Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Boston, MA 02215 (USA); and Center for Neurorehabilitation, Boston University.
Department of Physical Therapy, University of New England, Portland, Maine.
Phys Ther. 2019 Feb 1;99(2):203-216. doi: 10.1093/ptj/pzy131.
Declining physical activity commonly occurs in people with Parkinson disease (PD) and contributes to reduced functional capacity and quality of life.
The purpose of this study was to explore the preliminary effectiveness, safety, and acceptability of a mobile health (mHealth)-mediated exercise program designed to promote sustained physical activity in people with PD.
This was a 12-month single-blind (assessor), pilot, comparative-effectiveness, randomized controlled study.
An mHealth-mediated exercise program (walking with a pedometer plus engagement in planned exercise supported by a mobile health application) was compared over 1 year with an active control condition (walking with a pedometer and exercise only). There were 51 participants in a community setting with mild-to-moderately severe (Hoehn and Yahr stages 1-3) idiopathic PD. Daily steps and moderate-intensity minutes were measured using a step activity monitor for 1 week at baseline and again at 12 months. Secondary outcomes included the 6-Minute Walk Test, Parkinson Disease Questionnaire 39 mobility domain, safety, acceptability, and adherence.
Both groups increased daily steps, moderate-intensity minutes, and 6-Minute Walk Test, with no statistically significant between-group differences observed. In the less active subgroup, changes in daily steps and moderate-intensity minutes were clinically meaningful. An improvement in the Parkinson Disease Questionnaire 39 mobility score favored mHealth in the overall comparison and was statistically and clinically meaningful in the less active subgroup.
The limitation of the current study was the small sample size.
Both groups improved physical activity compared with expected activity decline over 1 year. The addition of the mHealth app to the exercise intervention appeared to differentially benefit the more sedentary participants. Further study in a larger group of people with low activity at baseline is needed.
在帕金森病（PD）患者中，体力活动减少很常见，这会导致其功能能力和生活质量下降。
本研究旨在探讨一种移动健康（mHealth）介导的运动方案对促进 PD 患者持续体力活动的初步效果、安全性和可接受性。
这是一项为期 12 个月的单盲（评估者）、前瞻性、比较有效性、随机对照研究。
在社区环境中，mHealth 介导的运动方案（计步器步行加由移动健康应用支持的计划运动）与积极对照组（计步器步行加仅运动）进行了为期 1 年的比较。有 51 名参与者患有轻度至中度严重（Hoehn 和 Yahr 分期 1-3 级）特发性 PD。使用计步器在基线和 12 个月时各进行 1 周的日常步数和中等强度分钟测量。次要结果包括 6 分钟步行测试、帕金森病问卷 39 移动域、安全性、可接受性和依从性。
两组的日常步数、中等强度分钟数和 6 分钟步行测试均增加，且组间无统计学显著差异。在活动量较少的亚组中，日常步数和中等强度分钟数的变化具有临床意义。整体比较中，mHealth 对帕金森病问卷 39 移动域评分的改善更有利，在活动量较少的亚组中具有统计学和临床意义。
本研究的局限性在于样本量较小。
与 1 年内预期的活动减少相比，两组的体力活动均有所改善。在运动干预中加入 mHealth 应用程序似乎对更久坐的参与者有不同的益处。需要在基线活动量较低的更大人群中进行进一步研究。
