不同类型运动对帕金森病睡眠质量和结构的影响：一项单盲随机临床试验方案。

The Effect of Different Types of Exercise on Sleep Quality and Architecture in Parkinson Disease: A Single-Blinded Randomized Clinical Trial Protocol.

机构信息

Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Jewish Rehabilitation Hospital, Laval, Québec, Canada.

School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada.

出版信息

Phys Ther. 2024 Jan 1;104(1). doi: 10.1093/ptj/pzad073.

DOI:10.1093/ptj/pzad073

PMID:37354450

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10776310/

Abstract

OBJECTIVES

The purpose of this trial is to (1) determine the best exercise modality to improve sleep quality and sleep architecture in people with Parkinson disease (PD); (2) investigate whether exercise-induced improvements in sleep mediate enhancements in motor and cognitive function as well as other non-motor symptoms of PD; and (3) explore if changes in systemic inflammation after exercise mediate improvements in sleep.

METHODS

This is a multi-site, superiority, single-blinded randomized controlled trial. One hundred fifty persons with PD and sleep problems will be recruited and randomly allocated into 4 intervention arms. Participants will be allocated into 12 weeks of either cardiovascular training, resistance training, multimodal training, or a waiting list control intervention. Assessments will be conducted at baseline, immediately after each intervention, and 8 weeks after each intervention by blinded assessors. Objective sleep quality and sleep architecture will be measured with polysomnography and electroencephalography. Motor and cognitive function will be assessed with the Unified PD Rating Scale and the Scale for Outcomes in PD-Cognition, respectively. Subjective sleep quality, fatigue, psychosocial functioning, and quality of life will be assessed with questionnaires. The concentration of inflammatory biomarkers in blood serum will be assessed with enzyme-linked immunosorbent assays.

IMPACT

This study will investigate the effect of different types of exercise on sleep quality and architecture in PD, exploring interactions between changes in sleep quality and architecture with motor and cognitive function and other non-motor symptoms of the disease as well as mechanistic interactions between systemic inflammation and sleep. The results will provide important practical information to guide physical therapists and other rehabilitation professionals in the selection of exercise and the design of more personalized exercise-based treatments aimed at optimizing sleep, motor, and cognitive function in people with PD.

摘要

目的

本试验旨在：(1)确定改善帕金森病（PD）患者睡眠质量和睡眠结构的最佳运动方式；(2)研究运动引起的睡眠改善是否介导运动和认知功能以及其他 PD 非运动症状的增强；以及(3)探索运动后系统炎症的变化是否介导睡眠的改善。

方法

这是一项多中心、优势、单盲随机对照试验。将招募 150 名有睡眠问题的 PD 患者，并将其随机分配到 4 个干预组。参与者将被分配到 12 周的心血管训练、阻力训练、多模态训练或等待名单对照干预。评估将由盲法评估者在基线、每次干预后立即和每次干预后 8 周进行。客观睡眠质量和睡眠结构将通过多导睡眠图和脑电图进行测量。运动和认知功能将分别使用统一帕金森病评定量表和帕金森病认知量表进行评估。主观睡眠质量、疲劳、心理社会功能和生活质量将通过问卷进行评估。血清中炎症生物标志物的浓度将通过酶联免疫吸附试验进行评估。

影响

本研究将探讨不同类型的运动对 PD 患者睡眠质量和结构的影响，探索睡眠质量和结构变化与运动和认知功能以及疾病的其他非运动症状之间的相互作用，以及系统炎症与睡眠之间的机制相互作用。研究结果将为物理治疗师和其他康复专业人员提供重要的实践信息，指导他们选择运动方式，并设计更个性化的基于运动的治疗方法，以优化 PD 患者的睡眠、运动和认知功能。