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I 期随机单盲对照研究,旨在探讨有氧运动对退行性小脑疾病的潜在益处。

Phase I randomized single-blinded controlled study investigating the potential benefit of aerobic exercise in degenerative cerebellar disease.

机构信息

Department of Physical Medicine and Rehabilitation, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.

Department of Mechanical Engineering, Columbia University, New York, NY, USA.

出版信息

Clin Rehabil. 2020 May;34(5):584-594. doi: 10.1177/0269215520905073. Epub 2020 Feb 10.

Abstract

OBJECTIVES

To investigate whether people with cerebellar degeneration can perform rigorous aerobic exercise and to assess the clinical impact of training.

DESIGN

Randomized single-blinded controlled, feasibility study comparing aerobic training to no training.

SETTING

Home intervention, assessments conducted at an academic medical center.

SUBJECTS

Twenty individuals with cerebellar degeneration caused by a range of genetic disorders.

INTERVENTION

Aerobic training consisted of four weeks of stationary bicycle training, five times per week for 30-minute sessions. Intensity ranged from 65% to 80% of the participant's maximal heart rate determined during cardiopulmonary exercise testing.

MAIN MEASURES

Primary outcome measure was change in the Scale for the Assessment and Rating of Ataxia scores. Recruitment rate, adherence, drop-out, and adverse events were also determined. The treatment was considered technically feasible if participants achieved target training frequency, duration, and intensity.

RESULTS

The 20 participants mean age was 50 years (standard deviation 15.65 years) and average Scale for the Assessment and Rating of Ataxia score was 9.6 (standard deviation 3.13). Ten participants were randomized to aerobic training and 10 to no training. Seven participants in the aerobic group attained target training duration, frequency, and intensity. There was a mean reduction in ataxia severity of 2.1 points (standard deviation 1.26) with four weeks of aerobic training, whereas ataxia severity increased by 0.3 (standard deviation 0.62) in the control group over the same period. Walking speed, balance measures, and fitness also improved in individuals who performed aerobic exercise.

CONCLUSIONS

Rigorous aerobic training is feasible in people with cerebellar degeneration. Improvements in ataxia, balance, and gait are promising.

摘要

目的

研究小脑退行性变患者能否进行严格的有氧运动,并评估训练的临床影响。

设计

随机、单盲、对照、可行性研究,比较有氧运动与不运动。

地点

家庭干预,在学术医疗中心进行评估。

对象

20 名小脑退行性变患者,病因包括多种遗传疾病。

干预

有氧运动包括四周固定自行车训练,每周 5 次,每次 30 分钟。强度范围为心肺运动测试确定的参与者最大心率的 65%至 80%。

主要测量指标

主要结局测量指标为共济失调评估量表评分的变化。还确定了招募率、依从性、脱落和不良事件。如果参与者达到目标训练频率、持续时间和强度,则认为治疗是技术可行的。

结果

20 名参与者的平均年龄为 50 岁(标准差 15.65 岁),平均共济失调评估量表评分为 9.6(标准差 3.13)。10 名参与者随机分配到有氧运动组,10 名参与者分配到无训练组。有氧运动组有 7 名参与者达到了目标训练时间、频率和强度。经过四周的有氧运动,共济失调严重程度平均降低了 2.1 分(标准差 1.26),而对照组在同一时期共济失调严重程度增加了 0.3 分(标准差 0.62)。在进行有氧运动的个体中,步行速度、平衡测量和健康状况也得到了改善。

结论

严格的有氧运动在小脑退行性变患者中是可行的。改善共济失调、平衡和步态是有希望的。

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