家庭为基础的规定运动可改善帕金森病患者与平衡相关的活动，其效果与以中心为基础的运动相似：系统综述。
Home-based prescribed exercise improves balance-related activities in people with Parkinson's disease and has benefits similar to centre-based exercise: a systematic review.
机构信息
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia; Discipline of Physiotherapy, Faculty of Health, University of Canberra, Australia.
Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Australia.
出版信息
J Physiother. 2019 Oct;65(4):189-199. doi: 10.1016/j.jphys.2019.08.003. Epub 2019 Sep 11.
QUESTIONS
In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise?
DESIGN
Systematic review and meta-analysis of randomised and quasi-randomised controlled trials.
PARTICIPANTS
Adults diagnosed with idiopathic Parkinson's disease.
INTERVENTION
Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise.
OUTCOME MEASURES
The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life.
RESULTS
Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI -0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD -0.04, 95% CI -0.36 to 0.27) and quality of life (SMD -0.08, 95% CI -0.41 to 0.24).
CONCLUSION
Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise.
REGISTRATION
PROSPERO CRD 42018107331.
问题
与不干预相比，针对帕金森病患者的家庭规定运动是否能改善与平衡相关的活动和生活质量？家庭运动的效果是否与等效的中心运动相同？
设计
系统评价和随机对照试验的荟萃分析。
参与者
被诊断为特发性帕金森病的成年人。
干预措施
主要为家庭规定的运动（定义为至少三分之二的运动在家中完成）。该干预措施必须主要涉及针对步态和/或站立平衡的物理练习，与对照组（即仅常规护理、假干预或无物理治疗）或等效的主要基于中心的运动相比。
结果测量
主要结果是与平衡相关的活动，次要结果是步态速度、伯格平衡量表、功能伸展测试和生活质量。
结果
符合纳入标准的 16 项试验均纳入了荟萃分析。12 项试验比较了家庭规定运动与对照组，4 项试验比较了家庭规定运动与等效的中心运动。与对照组相比，家庭规定运动可改善与平衡相关的活动（SMD 0.21，95%CI 0.10 至 0.32）和步态速度（SMD 0.30，95%CI 0.12 至 0.49），但对生活质量无影响（SMD 0.11，95%CI -0.01 至 0.23）。家庭和中心运动对与平衡相关的活动（SMD -0.04，95%CI -0.36 至 0.27）和生活质量（SMD -0.08，95%CI -0.41 至 0.24）的影响相似。
结论
家庭规定运动可改善帕金森病患者与平衡相关的活动和步态速度，这些改善与等效的中心运动相似。
登记
PROSPERO CRD42018107331。
Zotero 插件