Wu Minmin, Tang Qiang, Wang Linjing, Zhang Mei, Song Wenjing, Teng Lili, Zhu Luwen
Department of Rehabilitation Medicine, Heilongjiang University of Chinese Medicine, Harbin, China.
The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.
Front Aging Neurosci. 2022 Jun 30;14:927315. doi: 10.3389/fnagi.2022.927315. eCollection 2022.
The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of motor function in patients with Parkinson's disease (PD) is controversial. The present study aimed to assess the effects of TCE on balance and gait outcomes, as well as motor symptoms in individuals with PD, and evaluate potential discrete moderators such as TCE dosage-related variables.
PubMed, Embase, Cochrane's Library, Web of Science, Medline, and Scopus were systematically searched from their dates of inception to February 2022. All studies were randomized controlled trials (RCTs) of TCE-based interventions for PD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges' g). The Physiotherapy Evidence Database was used to evaluate the methodological quality of the study.
Fifteen studies involving a total of 873 participants were included in the final analysis. The meta-analytic findings revealed significant improvements in balance outcomes [Berg Balance Scales (BBS) ( = 0.83, 95% CI = 0.37-1.29, = 0.000, I = 84%), time up and go (TUG) ( = -0.80, 95% CI = -1.13- -0.47, = 0.000, I = 81%), and the one legged blind balance test ( = 0.49, 95% CI = 0.13-0.86, = 0.01, I = 10%)], as well as gait outcomes [gait velocity ( = 0.28, 95% CI = 0.02-0.54, = 0.04, I = 64%), 6-min walking test (6MWT) ( = 0.32, 95% CI 0.01-0.62, = 0.04, = 15%), stride length ( = 0.25, 95% CI = 0.08-0.41, = 0.003, I = 42%)], and motor symptoms [Unified Parkinson's Disease Rating Scale part III (UPDRS-III) ( = -0.77, 95% CI = -1.06- -0.48, = 0.000, I = 76%)]. However, cadence ( = -0.03) and step length ( = 0.02) did not differ significantly. The moderator shows that the effects of TCE on BBS and gait velocity were moderated by Pedro score, exercise type, control group type, and number of sessions. Meta-regression found that TCE (exercise duration, number of sessions, and session duration) was significantly associated with improved UPDRS-III and BBS scores.
These findings provide evidence for the therapeutic benefits of TCE as an adjunct therapy for patients with PD. TEC dosage (high-intensity long sessions) may moderate some favorable effects.
PROSPERO, identifier CRD42022314686.
基于传统中式运动（TCE）的干预措施对帕金森病（PD）患者运动功能改善的疗效存在争议。本研究旨在评估TCE对PD患者平衡和步态结果以及运动症状的影响，并评估潜在的离散调节因素，如与TCE剂量相关的变量。
系统检索了PubMed、Embase、Cochrane图书馆、Web of Science、Medline和Scopus自创建至2022年2月的文献。所有研究均为基于TCE干预PD的随机对照试验（RCT）。采用随机效应荟萃分析模型和标准化均数差（Hedges' g）估计治疗效果。使用物理治疗证据数据库评估研究的方法学质量。
最终分析纳入了15项研究，共873名参与者。荟萃分析结果显示，平衡结果[伯格平衡量表（BBS）（g = 0.83，95%CI = 0.37 - 1.29，P = 0.000，I² = 84%）、起立行走测试（TUG）（g = -0.80，95%CI = -1.13 - -0.47，P = 0.000，I² = 81%）和单腿闭眼平衡测试（g = 0.49，95%CI = 0.13 - 0.86，P = 0.01，I² = 10%）]、步态结果[步态速度（g = 0.28，95%CI = 0.02 - 0.54，P = 0.04，I² = 64%）、6分钟步行试验（6MWT）（g = 0.32，95%CI 0.01 - 0.62，P = 0.04，I² = 15%）、步幅（g = 0.25，95%CI = 0.08 - 0.41，P = 0.003，I² = 42%）]和运动症状[帕金森病统一评分量表第三部分（UPDRS - III）（g = -0.77，95%CI = -1.06 - -0.48，P = 0.000，I² = 76%）]均有显著改善。然而，步频（g = -0.03）和步长（g = 0.02）无显著差异。调节因素显示，TCE对BBS和步态速度的影响受佩德罗评分、运动类型、对照组类型和疗程数的调节。荟萃回归发现，TCE（运动持续时间、疗程数和每次疗程持续时间）与UPDRS - III和BBS评分的改善显著相关。
这些发现为TCE作为PD患者辅助治疗的益处提供了证据。TCE剂量（高强度长疗程）可能会调节一些有益效果。
PROSPERO，标识符CRD42022314686。
