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功能性训练、自行车运动和运动游戏对帕金森病老年患者行走能力的影响:一项初步的随机对照单盲试验。

The Effects of Functional Training, Bicycle Exercise, and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial.

机构信息

Department of Physical Therapy, Federal University of Bahia, Salvador, Brazil.

Department of Physical Therapy, Federal University of Bahia, Salvador, Brazil.

出版信息

Arch Phys Med Rehabil. 2018 May;99(5):826-833. doi: 10.1016/j.apmr.2017.12.014. Epub 2018 Jan 11.

Abstract

OBJECTIVES

To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD).

DESIGN

A pilot randomized, controlled, single-blinded trial.

SETTING

A state reference health care center for elderly, a public reference outpatient clinic for the elderly.

PARTICIPANTS

Elderly individuals (≥60 years of age; N=62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank.

INTERVENTION

The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n=22); group 2 (G2) performed bicycle exercise (n=20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n=20).

MAIN OUTCOME MEASURES

The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale.

RESULTS

All groups showed significant improvements in 6MWT (G1 P=.008; G2 P=.001; G3 P=.005), SRT (G1 P<.001; G2 P=.001; G3 P=.003), and WHODAS 2.0 (G1 P=.018; G2 P=.019; G3 P=.041). Only G3 improved gait speed in 10MWT (P=.11). G1 (P=.014) and G3 (P=.004) improved quality of life. No difference was found between groups.

CONCLUSIONS

Eight weeks of exergaming can improve the walking capacity of elderly patients with PD. Exergame training had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants.

摘要

目的

比较功能训练、自行车运动和体感游戏对帕金森病(PD)老年患者行走能力的影响。

设计

一项前瞻性、随机、对照、单盲试验。

地点

州立老年保健中心,老年公共门诊。

参与者

根据伦敦脑库,患有特发性 PD(改良 Hoehn 和 Yahr 分期量表 2 至 3 期)的老年个体(≥60 岁;N=62)。

干预

参与者被随机分配到三组。第 1 组(G1)参加功能训练(n=22);第 2 组(G2)进行自行车运动(n=20),第 3 组(G3)使用 Kinect Adventures(Microsoft,Redmond,WA)体感游戏进行训练(n=20)。

主要观察指标

主要观察指标为 6 分钟步行测试(6MWT);次要观察指标为 10 米步行测试(10MWT)、坐起测试(SRT)、体重指数、帕金森病问卷-39 (PDQ-39)、世界卫生组织残疾评估量表 2.0(WHODAS 2.0)和 15 项老年抑郁量表。

结果

所有组在 6MWT(G1 P=.008;G2 P=.001;G3 P=.005)、SRT(G1 P<.001;G2 P=.001;G3 P=.003)和 WHODAS 2.0(G1 P=.018;G2 P=.019;G3 P=.041)方面均有显著改善。仅 G3 改善了 10MWT 的步态速度(P=.11)。G1(P=.014)和 G3(P=.004)改善了生活质量。组间无差异。

结论

8 周的体感游戏可以改善 PD 老年患者的行走能力。体感游戏训练与功能训练和自行车运动具有相似的效果。三种体育锻炼方式均能显著改善参与者的行走能力、站立和坐下能力以及功能。

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