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运动对多发性硬化症生活质量和临床运动症状的影响。

Exercise Effects on Multiple Sclerosis Quality of Life and Clinical-Motor Symptoms.

机构信息

Somogy County Kaposi Mór Teaching Hospital, Kaposvár, HUNGARY.

Department of Pharmacology, Surveillance, and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, HUNGARY.

出版信息

Med Sci Sports Exerc. 2020 May;52(5):1007-1014. doi: 10.1249/MSS.0000000000002228.

Abstract

INTRODUCTION

Different therapies can improve clinical and motor symptoms of multiple sclerosis (MS) similarly, but studies comparing the effects of different exercise therapies on clinical and motor outcomes are scant. We compared the effects of exergaming (EXE), balance (BAL), cycling (CYC), proprioceptive neuromuscular facilitation (PNF), and a standard care wait-listed control group (CON) on clinical and motor symptoms and quality of life (QoL) in people with MS (PwMS).

METHODS

PwMS (n = 68, 90% female; age, 47.0 yr; Expanded Disability Status Scale score 5-6) were randomized into five groups. Before and after the interventions (five times a week for 5 wk), PwMS were tested for MS-related clinical and motor symptoms (Multiple Sclerosis Impact Scale-29 (MSIS-29), primary outcome), QoL (EuroQol Five Dimensions Questionnaire), symptoms of depression, gait and balance ability (Tinetti Assessment Tool), static and dynamic balance and fall risk (Berg Balance Scale), walking capacity (6-min walk test), and standing posturography on a force platform.

RESULTS

EXE, BAL, and CYC improved the MSIS-29 scores similarly. EXE and CYC improved QoL and walking capacity similarly but more than BAL. Only EXE improved gait and balance scores (Tinetti Assessment Tool). EXE and BAL improved fall risk and standing balance similarly but more than CYC. PNF and CON revealed no changes. The EuroQol Five Dimensions Questionnaire moderated the exercise effects on the MSIS-29 scores only in EXE. Changes in QoL and changes in the MSIS-29 scores correlated (R = 0.73) only in EXE.

CONCLUSION

In conclusion, BAL and CYC but EXE in particular, but not PNF, can improve clinical and motor symptoms and QoL in PwMS (Expanded Disability Status Scale score 5 to 6), expanding the evidence-based exercise options to reduce mobility limitations in PwMS.

摘要

简介

不同的疗法可以同样改善多发性硬化症(MS)的临床和运动症状,但比较不同运动疗法对临床和运动结果影响的研究很少。我们比较了电子游戏(EXE)、平衡(BAL)、骑行(CYC)、本体感觉神经肌肉促进法(PNF)和标准护理候补对照组(CON)对 MS 患者(PwMS)的临床和运动症状以及生活质量(QoL)的影响。

方法

将 68 名 PwMS(90%为女性;年龄 47.0 岁;扩展残疾状况量表评分 5-6)随机分为五组。在干预措施前后(每周 5 次,持续 5 周),对 PwMS 进行了与 MS 相关的临床和运动症状(多发性硬化症影响量表-29(MSIS-29),主要结果)、QoL(欧洲五维健康量表)、抑郁症状、步态和平衡能力(Tinetti 评估工具)、静态和动态平衡和跌倒风险(伯格平衡量表)、步行能力(6 分钟步行测试)以及力平台上的站立姿势测试。

结果

EXE、BAL 和 CYC 改善 MSIS-29 评分的效果相似。EXE 和 CYC 改善 QoL 和步行能力的效果相似,但优于 BAL。只有 EXE 改善了步态和平衡评分(Tinetti 评估工具)。EXE 和 BAL 改善跌倒风险和站立平衡的效果相似,但优于 CYC。PNF 和 CON 没有变化。仅在 EXE 中,欧洲五维健康量表调节了运动对 MSIS-29 评分的影响。QoL 的变化与 MSIS-29 评分的变化相关(R=0.73),仅在 EXE 中。

结论

总之,BAL 和 CYC 但特别是 EXE,但不是 PNF,可以改善 PwMS(扩展残疾状况量表评分 5-6)的临床和运动症状以及 QoL,为减少 PwMS 的活动能力限制提供了循证运动选择。

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