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经过 12 周适应性探戈治疗后,一名非裔美国皮质基底节变性患者的移动能力、认知能力和疾病严重程度得到改善:一项病例研究。

Improved Mobility, Cognition, and Disease Severity in Corticobasal Degeneration of an African American Man After 12 Weeks of Adapted Tango: A Case Study.

机构信息

From the Division of General Medicine and Geriatrics, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia (HAS, ARH, MEH); and Atlanta Veterans Affairs Rehabilitation R&D Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia (AB, MEH).

出版信息

Am J Phys Med Rehabil. 2020 Feb;99(2):e21-e27. doi: 10.1097/PHM.0000000000001165.

Abstract

Corticobasal degeneration (CBD) has no available treatment to slow disease progression and generally resists drug therapy. Corticobasal degeneration has symptoms and decreased quality of life similar to Parkinson disease. Adapted Tango, a successful rehabilitation for Parkinson, may address CBD. A 63-yr-old African American man with CBD (alias: YD; CBD duration = 2 yrs) was evaluated for motor, cognitive, and psychosocial function before, immediately after, 1 mo after, and 6 mos after 12 wks of 20, biweekly 90-min adapted-tango lessons. After intervention, disease-related motor symptoms improved and YD reported fewer problems in nonmotor experiences of daily living, which include mood, cognition, pain, fatigue, etc. Motor symptoms remained above baseline at 6-mo posttest. YD's balance confidence improved after intervention but declined below baseline at 6-mo posttest. Quality of life was maintained despite worsened depression. YD improved or maintained executive function, and visuospatial function and attention at posttest and 1-mo posttest. At posttest, YD maintained mobility and improved on dynamic balance. At 1-mo posttest, most mobility measures had improved relative to baseline. However, YD showed executive function and overall motor decline 6 mos after intervention. Adapted tango may have temporarily slowed disease progression and improved or maintained mobility and cognition. Gains were poorly maintained after 6 mos. Further study is warranted.

摘要

皮质基底节变性(CBD)目前尚无治疗方法可以减缓疾病进展,通常对药物治疗有抵抗力。皮质基底节变性的症状和生活质量下降与帕金森病相似。改编探戈舞,一种成功的帕金森康复方法,可能适用于 CBD。一名 63 岁的非洲裔美国 CBD 患者(化名:YD;CBD 持续时间=2 年)在接受为期 12 周、每周 2 次、每次 90 分钟的 20 次改编探戈课程治疗前、治疗后即刻、1 个月后和 6 个月后进行了运动、认知和社会心理功能评估。干预后,疾病相关的运动症状得到改善,YD 报告日常生活中非运动体验中的问题(包括情绪、认知、疼痛、疲劳等)减少。运动症状在 6 个月后测试仍高于基线。YD 的平衡信心在干预后有所提高,但在 6 个月后测试时下降至低于基线。尽管抑郁恶化,但生活质量得以维持。YD 在测试和 1 个月后测试时的执行功能、视空间功能和注意力都得到了改善或保持。在测试时,YD 保持了活动能力并改善了动态平衡。在 1 个月后测试时,与基线相比,大多数移动性测量值都有所提高。然而,YD 在干预后 6 个月时表现出执行功能和整体运动能力下降。改编探戈舞可能暂时减缓了疾病进展,改善或保持了运动能力和认知能力。但在 6 个月后,获益难以维持。需要进一步研究。

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本文引用的文献

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Dramatic Improvement of Parkinsonism While Dancing Tango.跳探戈时帕金森症状显著改善
Mov Disord Clin Pract. 2014 Oct 23;1(4):388-389. doi: 10.1002/mdc3.12067. eCollection 2014 Dec.
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Cognitive dysfunction in corticobasal degeneration.皮质基底节变性中的认知功能障碍。
Arq Neuropsiquiatr. 2017 Aug;75(8):570-579. doi: 10.1590/0004-282X20170077.
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Time Trends in the Incidence of Parkinson Disease.帕金森病发病率的时间趋势。
JAMA Neurol. 2016 Aug 1;73(8):981-9. doi: 10.1001/jamaneurol.2016.0947.
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Gait speed and related factors in Parkinson's disease.帕金森病中的步态速度及相关因素
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