Wang Kai, Li Kunbin, Zhang Peiming, Ge Shuqi, Wen Xiaopeng, Wu Zhiyuan, Yao Xianli, Jiao Bing, Sun Pingge, Lv Peipei, Lu Liming
Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Aging Neurosci. 2021 Dec 3;13:770920. doi: 10.3389/fnagi.2021.770920. eCollection 2021.
This study aimed to systematically evaluate the effects of mind-body exercise on global cognitive function, depression, sleep disorders, fatigue level, and quality of life (QOL) in a Parkinson's disease (PD) population. Total six English and Chinese databases were searched for articles published up to May 2021. Randomized controlled trials (RCTs) evaluating mind-body excises on non-motor symptoms of PD were included. The Cochrane risk of bias tool was used to assess the methodological quality, and we defined high-quality studies as having a low risk of bias in four or more domains. Global cognitive function was considered the primary outcome and was assessed using the Montreal Cognitive Assessment (MoCA). The secondary outcomes included QOL, fatigue, depression, and sleep quality, which were measured using the Parkinson's Disease Questionnaire (PDQ-39), 16-item Parkinson's Disease Fatigue Scale (PFS-16), Beck Depression Inventory (BDI), and revised Parkinson's Disease Sleep Scale (PDSS-2), respectively. Subgroup analyses were conducted for global cognitive function and QOL to assess the optimal treatment measure across the various mind-body exercises. Fourteen RCTs with 404 patients were finally included in the meta-analysis. Eight (57.14%) studies were of high quality. The pooled results showed that mind-body exercises generally had a significant advantage over the control intervention in improving global cognitive function (MD = 1.68; = 0.0008). The dose subgroup analysis revealed that the low dose (60-120 min per week) and moderate dose (120-200 min per week) significantly increased MoCA scores compared with the control group (MD = 2.11, = 0.01; MD = 1.27, = 0.02, respectively). The duration subgroup analysis indicated a significant difference in the effect of the duration (6-10 and >15 weeks) on increasing MoCA scores compared with the control group (MD = 3.74, < 0.00001; MD = 1.45, = 0.01, respectively). Mind-body exercise may improve global cognitive function, sleep quality, and QOL in the PD population. In addition, low to moderate doses and appropriate durations significantly improved global cognitive function. [www.ClinicalTrials.gov], identifier [CRD42021275522].
本研究旨在系统评估身心锻炼对帕金森病（PD）患者的整体认知功能、抑郁、睡眠障碍、疲劳水平和生活质量（QOL）的影响。检索了总共六个英文和中文数据库，以查找截至2021年5月发表的文章。纳入了评估身心锻炼对PD非运动症状影响的随机对照试验（RCT）。使用Cochrane偏倚风险工具评估方法学质量，我们将高质量研究定义为在四个或更多领域中偏倚风险较低的研究。整体认知功能被视为主要结局，并使用蒙特利尔认知评估量表（MoCA）进行评估。次要结局包括生活质量、疲劳、抑郁和睡眠质量，分别使用帕金森病问卷（PDQ-39）、16项帕金森病疲劳量表（PFS-16）、贝克抑郁量表（BDI）和修订版帕金森病睡眠量表（PDSS-2）进行测量。对整体认知功能和生活质量进行亚组分析，以评估各种身心锻炼中的最佳治疗措施。最终，14项涉及404例患者的RCT被纳入荟萃分析。其中八项（57.14%）研究质量较高。汇总结果显示，在改善整体认知功能方面，身心锻炼总体上比对照干预具有显著优势（MD = 1.68；P = 0.0008）。剂量亚组分析显示，与对照组相比，低剂量（每周60 - 120分钟）和中等剂量（每周120 - 200分钟）显著提高了MoCA评分（MD分别为2.11，P = 0.01；MD = 1.27，P = 0.02）。持续时间亚组分析表明，与对照组相比，不同持续时间（6 - 10周和>15周）在提高MoCA评分方面的效果存在显著差异（MD分别为3.74，P < 0.00001；MD = 1.45，P = 0.01）。身心锻炼可能改善PD患者的整体认知功能、睡眠质量和生活质量。此外，低至中等剂量以及适当的持续时间可显著改善整体认知功能。[www.ClinicalTrials.gov]，标识符[CRD42021275522]
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