Brognara Lorenzo, Cauli Omar
Department of Biomedical and Neuromotor Science, University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy.
Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain.
Diseases. 2020 May 10;8(2):12. doi: 10.3390/diseases8020012.
Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in older individuals. Neurorehabilitation-based interventions such as those improving gait are crucial for a holistic approach and to limit falls. Several studies have recently shown that mechanical plantar foot stimulation is a beneficial intervention for improving gait impairment in PD patients. The objective of this scoping review is to evaluate the beneficial effects of this stimulation on gait parameters, and to analyse protocols of foot stimulation and other effects in non-motor symptoms. Relevant articles were searched in the Medline database using Pubmed and Scopus, using the primary search terms 'foot stimulation' OR 'plantar stimulation' AND 'Parkinson's disease*'. Several protocols have been used for mechanical plantar foot stimulation (ranging from medical devices to textured insoles). The gait parameters that have been shown to be improved are stride length and walking speed. The beneficial effects are achieved after both acute and repeated plantar foot stimulation. Beneficial effects are observed in other organs and systems, such as muscle activation, brain connectivity, cardiovascular control in the central nervous system, and the release of brain-derived neurotrophic factor and cortisol in blood added evidence about this intervention's impact on brain function. Mechanical plantar foot stimulation is a safe and effective add-on treatment able for improving gait impairments in PD patients during the L-dopa off state. Randomized and controlled clinical trials to study its eventual potentiating effect with different pharmacotherapy regimens are warranted.
帕金森病（PD）是老年人中第二常见的神经退行性疾病。基于神经康复的干预措施，如改善步态的措施，对于整体治疗方法和减少跌倒至关重要。最近的几项研究表明，机械性足底刺激是改善帕金森病患者步态障碍的有益干预措施。本综述的目的是评估这种刺激对步态参数的有益影响，并分析足部刺激方案以及对非运动症状的其他影响。使用PubMed和Scopus在Medline数据库中搜索相关文章，主要搜索词为“足部刺激”或“足底刺激”以及“帕金森病*”。已经使用了几种机械性足底刺激方案（从医疗设备到纹理鞋垫）。已显示得到改善的步态参数包括步幅长度和步行速度。急性和反复足底刺激后均能产生有益效果。在其他器官和系统中也观察到有益效果，如肌肉激活、脑连接性、中枢神经系统中的心血管控制，以及血液中脑源性神经营养因子和皮质醇的释放，这些都进一步证明了这种干预对脑功能的影响。机械性足底刺激是一种安全有效的辅助治疗方法，能够在左旋多巴停药状态下改善帕金森病患者的步态障碍。有必要进行随机对照临床试验，以研究其与不同药物治疗方案的最终增效作用。
