Tofani Marco, Ranieri Alessandro, Fabbrini Giovanni, Berardi Anna, Pelosin Elisa, Valente Donatella, Fabbrini Andrea, Costanzo Matteo, Galeoto Giovanni
Department of Public Health and Infectious Diseases Sapienza University of Rome Rome Italy.
Department of Anatomy and Locomotor Activity Sapienza University of Rome Rome Italy.
Mov Disord Clin Pract. 2020 Oct 2;7(8):891-901. doi: 10.1002/mdc3.13089. eCollection 2020 Nov.
To review studies assessing the efficacy of occupational therapy interventions on quality of life in patients with Parkinson's disease.
We followed the international guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Databases (PubMed, Physiotherapy Evidence Database, OTsekeer, Scopus, Cinhal, and Web of Science) were searched to identify randomized controlled trials of occupational therapy interventions in patients with Parkinson's disease up to 2019 and with no restriction on language. The primary outcome of the meta-analysis was the evaluation of quality of life following occupational therapy interventions. Because of the heterogeneity of the studies, we examined the data by using a random effect model.
We identified 15 randomized controlled trials that met the inclusion criteria, and 4 of these were included in the meta-analysis. Studies with a follow-up of 2 to 3 months showed that occupational therapy interventions significantly improved the quality of life in patients with Parkinson's disease, with a mean difference of -2.08 (95% confidence interval, -2.52 to -1.64; < 0.00001). Studies reporting a longer follow-up (6-12 months) also showed that occupational therapy interventions improved the quality of life, with a mean difference of -2.56 (95% confidence interval, -3.52 to -1.61; < 0.00001).
Different occupational therapy interventions may be effective in improving the quality of life in patients with Parkinson's disease. However, because of the limited number of studies available, the strength of the evidence should be considered moderate.
回顾评估职业治疗干预对帕金森病患者生活质量疗效的研究。
我们遵循系统评价和Meta分析的首选报告项目清单的国际指南。检索数据库（PubMed、物理治疗证据数据库、OTsekeer、Scopus、Cinhalt和科学网），以识别截至2019年帕金森病患者职业治疗干预的随机对照试验，且对语言无限制。Meta分析的主要结果是评估职业治疗干预后的生活质量。由于研究的异质性，我们使用随机效应模型检查数据。
我们确定了15项符合纳入标准的随机对照试验，其中4项纳入Meta分析。随访2至3个月的研究表明，职业治疗干预显著改善了帕金森病患者的生活质量，平均差异为-2.08（95%置信区间，-2.52至-1.64；P<0.00001）。报告更长随访时间（6至12个月）的研究也表明，职业治疗干预改善了生活质量，平均差异为-2.56（95%置信区间，-3.52至-1.61；P<0.00001）。
不同的职业治疗干预可能有效改善帕金森病患者的生活质量。然而，由于现有研究数量有限，证据强度应被视为中等。
