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综合性帕金森病健康计划的功能结局

Functional outcomes of an integrated Parkinson's Disease Wellbeing Program.

作者信息

Horne Jeremey T, Soh Derrick, Cordato Dennis J, Campbell Megan L, Schwartz Raymond S

机构信息

Department of Physiotherapy, Calvary Hospital, Kogarah, Sydney, New South Wales, Australia.

Department of Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.

出版信息

Australas J Ageing. 2020 Mar;39(1):e94-e102. doi: 10.1111/ajag.12705. Epub 2019 Jul 25.

Abstract

INTRODUCTION

There is growing evidence that exercise provides benefit in treating motor and non-motor symptoms in Parkinson's disease (PD).

OBJECTIVES

The aims of this study were to determine (a) whether a 5-week PD-specific program resulted in sustained physical and psychosocial benefits, and (b) the relationship between patient characteristics, exercise, falls and physical and psychosocial parameters.

DESIGN

Single-centre prospective observational study.

METHODS

A total of 135 consecutive patients with mild-to-moderate PD underwent a 5-week PD-specific education and exercise program from August 2013 to March 2015. Gait, mobility and psychosocial measures were compared at baseline, 6 weeks and 12 months.

RESULTS

Significant improvements in physical (walking distance in 2 minutes, number of "Sit To Stands" in 30 seconds, time in seconds taken to "Timed Up and Go," fast gait velocity over 10 m, Berg Balance Scale [BBS]) and psychosocial (quality of life (QoL) [PDQ-39], depression and anxiety [DASS-21], and fatigue [PSF-16]) measures were seen at 6 weeks (all P < .01) with physical improvements sustained at 12 months (all P < .001). The number of patients at 12 months with ≥1 fall reduced from 66% to 33%, and the number not exercising reduced from 42% to 21%. A lack of exercise correlated with ≥1 fall at 12 months (OR 3.39, 95% CI 1.36-8.39, P = .009). It was also associated with poorer balance and psychosocial parameters at 12 months (all P < .05).

CONCLUSIONS

Patients recruited into a 5-week Parkinson's disease education and exercise program achieved significant 12-month benefits in physical but not psychosocial measures. Patients with ≥1 fall post-treatment were less likely to have been exercising at 12-month follow-up.

摘要

引言

越来越多的证据表明,运动对治疗帕金森病(PD)的运动和非运动症状有益。

目的

本研究的目的是确定(a)为期5周的帕金森病特定项目是否能带来持续的身体和心理社会效益,以及(b)患者特征、运动、跌倒与身体和心理社会参数之间的关系。

设计

单中心前瞻性观察研究。

方法

2013年8月至2015年3月,共有135例连续的轻至中度帕金森病患者接受了为期5周的帕金森病特定教育和运动项目。在基线、6周和12个月时比较步态、活动能力和心理社会指标。

结果

6周时,身体指标(2分钟步行距离、30秒内“从坐到站”次数、“计时起立行走”所需时间、10米以上快速步态速度、伯格平衡量表[BBS])和心理社会指标(生活质量[QoL][PDQ-39]、抑郁和焦虑[DASS-21]以及疲劳[PSF-16])均有显著改善(所有P<.01),身体改善在12个月时得以维持(所有P<.001)。12个月时发生≥1次跌倒的患者数量从66%降至33%,未运动的患者数量从42%降至21%。缺乏运动与12个月时发生≥1次跌倒相关(比值比3.39,95%置信区间1.36-8.39,P=.009)。它还与12个月时较差的平衡和心理社会参数相关(所有P<.05)。

结论

参与为期5周的帕金森病教育和运动项目的患者在12个月时身体指标有显著改善,但心理社会指标无改善。治疗后发生≥1次跌倒的患者在12个月随访时运动的可能性较小。

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