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基于运动游戏的干预措施对帕金森病老年患者移动和平衡能力的效果:随机对照试验的系统评价和荟萃分析。

Effectiveness of exergaming-based interventions for mobility and balance performance in older adults with Parkinson's disease: systematic review and meta-analysis of randomised controlled trials.

机构信息

School of Design, The Hong Kong Polytechnic University, Hong Kong SAR, China.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.

出版信息

Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac175.

Abstract

BACKGROUND

exergaming-based interventions (EbIs) have been proposed to improve older adults' mobility and balance performance. However, the effectiveness of such interventions for older adults with Parkinson's disease (OAPD) remains unclear.

METHODS

seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE and PubMed) were searched up to 7 April 2022. We assessed mobility and balance performance between EbIs groups and control groups or traditional physical training interventions (TPTIs) groups by comparing the outcomes of the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), Berg Balance Scale (BBS), gait velocity, stride length and Functional Gait Assessment (FGA).

RESULTS

we scanned 1,190 articles and meta-analysed 19 trials (sample size = 781). In general, the results revealed statistical differences between EbIs groups and TPTIs groups in the TUG [mean difference (MD) = -1.030 s; 95% confidence interval (CI) = -2.029 to -0.031; P = 0.043; high quality of evidence], 6MWT (MD = 63.483 m; 95% CI = 9.542 to 117.425; P = 0.021; moderate quality of evidence), BBS (MD = 2.129; 95% CI = -1.293 to 2.965; P < 0.001; high quality of evidence) and FGA (MD = 2.099 95% CI = -0.306 to 3.893; P = 0.022; moderate quality of evidence). No significant difference was discovered between EbIs groups and TPTIs groups in enhancing gait velocity and stride length.

CONCLUSIONS

EbIs are statistically better than TPTIs in improving OAPD's performance in TUG, 6MWT, BBS and FGA, whereas only the change between EbIs and TPTIs in 6MWT can reach the value of minimal clinically important difference. Further studies are needed to better assess the effectiveness of exergaming-based interventions.

摘要

背景

基于运动游戏的干预(EbI)已被提出用于改善老年人的移动性和平衡能力。然而,对于帕金森病(OAPD)老年人,此类干预的效果仍不清楚。

方法

检索了 7 个数据库(Web of Science、Medline、Academic Search Premier、CINAHL Complete、PsycINFO、PsychARTICLE 和 PubMed),检索截至 2022 年 4 月 7 日。我们通过比较定时起立行走测试(TUG)、6 分钟步行测试(6MWT)、伯格平衡量表(BBS)、步态速度、步幅和功能性步态评估(FGA)的结果,比较 EbI 组与对照组或传统体育训练干预(TPTI)组之间的移动性和平衡能力。

结果

我们扫描了 1190 篇文章,并对 19 项试验进行了荟萃分析(样本量=781)。总体而言,EbI 组与 TPTI 组在 TUG [平均差值(MD)=-1.030 s;95%置信区间(CI)=-2.029 至-0.031;P=0.043;高质量证据]、6MWT(MD=63.483 m;95%CI=9.542 至 117.425;P=0.021;中等质量证据)、BBS(MD=2.129;95%CI=1.293 至 2.965;P<0.001;高质量证据)和 FGA(MD=2.099;95%CI=0.306 至 3.893;P=0.022;中等质量证据)方面的差异具有统计学意义。EbI 组与 TPTI 组在提高步态速度和步幅方面无显著差异。

结论

与 TPTI 相比,EbI 在改善 OAPD 的 TUG、6MWT、BBS 和 FGA 表现方面具有统计学优势,而只有 EbI 与 TPTI 之间的 6MWT 变化才能达到最小临床重要差异的价值。需要进一步的研究来更好地评估基于运动游戏的干预措施的效果。

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