运动对肌萎缩侧索硬化症患者的影响：系统评价和荟萃分析。

Effects of Exercise in Patients With Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis.

机构信息

From the Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu Sichuan, China (LM, XL, CL, YC, YG, QG); Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu Sichuan, China (LM, CL, YG, QG); and MacLehose Medical Rehabilitation Center, HKSAR, China (RCCT).

出版信息

Am J Phys Med Rehabil. 2020 Sep;99(9):801-810. doi: 10.1097/PHM.0000000000001419.

DOI:10.1097/PHM.0000000000001419

PMID:32452880

Abstract

OBJECTIVE

The aim of this study was to systematically review the efficacy and safety of exercise in patients with amyotrophic lateral sclerosis (ALS).

DESIGN

Randomized controlled trials of exercises for ALS were searched in PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine database, China National Knowledge Internet, VIP database, and Wanfang database. The primary outcomes were functional ability, pulmonary function, and quality of life. The secondary outcomes were muscle strength, fatigue and adverse events. Meta-analysis was performed using the RevMan Version 5.3 software.

RESULTS

Seven randomized controlled trials including 322 patients with ALS met the inclusion criteria. Meta-analysis showed that the functional scores at long-term (standardized means difference, 0.47; 95% confidence interval, 0.08-0.86; P = 0.02) and forced vital capacity percentage predicted (mean difference, 1.71; 95% confidence interval, 0.10-3.31; P = 0.04) of patients with ALS in the exercise group were significantly higher than those in the group of no exercise or usual care. No significant difference was observed in muscle strength and quality of life. Endurance or aerobic exercise improved the functional scores of patients with ALS (standardized means difference, 0.36; 95% confidence interval, 0.04-0.68; P = 0.03). Exercise did not aggravate fatigue or result in adverse event.

CONCLUSION

Exercise can significantly improve the functional ability and pulmonary function of patients with ALS safely.

摘要

目的

本研究旨在系统评价运动疗法对肌萎缩侧索硬化症（ALS）患者的疗效和安全性。

设计

检索 PubMed、EMBASE、Web of Science、Cochrane 图书馆、中国生物医学文献数据库、中国知网、维普及万方数据库中关于运动疗法治疗 ALS 的随机对照试验。主要结局指标为功能能力、肺功能和生活质量。次要结局指标为肌肉力量、疲劳和不良事件。使用 RevMan Version 5.3 软件进行荟萃分析。

结果

纳入的 7 项随机对照试验共 322 例 ALS 患者符合纳入标准。荟萃分析显示，运动组患者的长期功能评分（标准化均数差，0.47；95%置信区间，0.08-0.86；P=0.02）和用力肺活量预计值百分比（均数差，1.71；95%置信区间，0.10-3.31；P=0.04）明显高于不运动或常规护理组。两组患者的肌肉力量和生活质量无明显差异。耐力或有氧运动可改善 ALS 患者的功能评分（标准化均数差，0.36；95%置信区间，0.04-0.68；P=0.03）。运动疗法不会加重疲劳或导致不良事件。