Horne Jeremey T, Soh Derrick, Cordato Dennis J, Campbell Megan L, Schwartz Raymond S
Department of Physiotherapy, Calvary Hospital, Kogarah, Sydney, New South Wales, Australia.
Department of Neurophysiology, Liverpool Hospital, Sydney, New South Wales, Australia.
Australas J Ageing. 2020 Mar;39(1):e94-e102. doi: 10.1111/ajag.12705. Epub 2019 Jul 25.
There is growing evidence that exercise provides benefit in treating motor and non-motor symptoms in Parkinson's disease (PD).
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.
Single-centre prospective observational study.
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.
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).
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.
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。
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。
单中心前瞻性观察研究。
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。
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）。
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。
