Department Rehabilitation Sciences, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Neurological Centre, Segeberger Kliniken GmbH, Bad Segeberg, Germany.
BMC Neurol. 2022 May 14;22(1):176. doi: 10.1186/s12883-022-02647-9.
Regular physical activity is of great relevance in Parkinson's disease (PD). It is part of the inpatient multimodal Parkinson's complex treatment (MKP) in Germany. However, there is often a lack of human resources in outpatient settings to continue an interprofessional approach. A large proportion of PD patients live a predominantly sedentary lifestyle and do not get enough exercise.
The intervention group (IG) used a tablet-based physiotherapy training programme at home for a period of nine months. We conducted a quasi-randomised longitudinal study with three measurement times (at the beginning (t) and end of MKP (t) and at 9 months after MKP (t)). The primary outcome measured was PD-specific quality of life using the PDQ-8. The secondary outcome focused on participation restrictions, falling anxiety, sleep disorder, anxiety and depression as well as comorbidity, pain, performance capability and physical activity.
For n = 93 IG and n = 137 control group (CG) patients, evaluable cases were available for all measurement times. Both groups achieved significant improvements in all parameters at the end of MKP. These parameters deteriorated again at nine months after MKP for most parameters and were even below the baseline levels. However, this deterioration was less pronounced in the IG than in the CG. For general health and social participation, a significant slightly positive effect was observed in the IG nine months after MKP when compared with the baseline level. Paying attention to physical activity slightly increased in the IG for the catamnesis survey compared to baseline. Nearly all IG patients were satisfied with the intervention, especially with the consultations with the physiotherapist.
Although the expected extent of effects could not be determined for the IG, stabilisation effects could be demonstrated. These stabilisation effects shown for the IG might be attributed to the intervention. The effects might have been greater without the COVID-19 pandemic.
German Register of Clinical Trials, drks.de. Identifier: DRKS00014952. Registered 20/06/2018. Date and version identifier 25/04/2019; version 1.
有规律的身体活动对帕金森病（PD）患者具有重要意义。在德国，它是住院多模式帕金森综合治疗（MKP）的一部分。然而，在门诊环境中，通常缺乏人力资源来继续采用跨专业的方法。很大一部分 PD 患者过着久坐不动的生活方式，运动不足。
干预组（IG）在家中使用基于平板电脑的物理治疗训练方案，为期九个月。我们进行了一项准随机纵向研究，共测量了三次（在 MKP 开始时（t）和结束时（t）以及 MKP 结束后 9 个月时（t））。主要结局指标是使用 PDQ-8 评估 PD 特异性生活质量。次要结局指标侧重于参与限制、跌倒焦虑、睡眠障碍、焦虑和抑郁以及合并症、疼痛、表现能力和身体活动。
对于 n=93 例 IG 和 n=137 例对照组（CG）患者，所有测量时间均有可评估病例。两组在 MKP 结束时所有参数均显著改善。在 MKP 结束后 9 个月，大多数参数再次恶化，甚至低于基线水平。然而，IG 组的恶化程度低于 CG 组。对于一般健康和社会参与，IG 在 MKP 结束后 9 个月时与基线水平相比，观察到显著的略微正效应。在随访调查中，IG 对身体活动的关注度略有增加。几乎所有 IG 患者都对干预措施表示满意，特别是对与物理治疗师的咨询感到满意。
尽管无法确定 IG 的预期效果程度，但可以证明稳定效果。IG 显示的这些稳定效果可能归因于干预措施。如果没有 COVID-19 大流行，效果可能会更大。
德国临床试验注册处，drks.de。标识符：DRKS00014952。注册于 2018 年 6 月 20 日。日期和版本标识符为 2019 年 4 月 25 日；版本 1。
