Gomes Elvira S Amaral, Van den Heuvel Odile A, Rietberg Marc B, De Groot Vincent, Hirsch Mark A, Van de Berg Wilma D J, Jaspers Richard T, Vriend Chris, Vanbellingen Tim, Van Wegen Erwin E H
Department of Rehabilitation Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands.
Brain Sci. 2023 May 24;13(6):849. doi: 10.3390/brainsci13060849.
INTRODUCTION: Physical exercise is receiving increasing interest as an augmentative non-pharmacological intervention in Parkinson's disease (PD). This pilot study primarily aimed to quantify individual response patterns of motor symptoms to alternating exercise modalities, along with non-motor functioning and blood biomarkers of neuroplasticity and neurodegeneration. MATERIALS & METHODS: People with PD performed high-intensity interval training (HIIT) and continuous aerobic exercise (CAE) using a crossover single-case experimental design. A repeated assessment of outcome measures was conducted. The trajectories of outcome measures were visualized in time series plots and interpreted relative to the minimal clinically important difference (MCID) and smallest detectable change (SDC) or as a change in the positive or negative direction using trend lines. RESULTS: Data of three participants were analyzed and engaging in physical exercise seemed beneficial for reducing motor symptoms. Participant 1 demonstrated improvement in motor function, independent of exercise modality; while for participant 2, such a clinically relevant (positive) change in motor function was only observed in response to CAE. Participant 3 showed improved motor function after HIIT, but no comparison could be made with CAE because of drop-out. Heterogeneous responses on secondary outcome measures were found, not only between exercise modalities but also among participants. CONCLUSION: Though this study underpins the positive impact of physical exercise in the management of PD, large variability in individual response patterns to the interventions among participants makes it difficult to identify clear exercise-induced adaptations in functioning and blood biomarkers. Further research is needed to overcome methodological challenges in measuring individual response patterns.
引言:体育锻炼作为帕金森病(PD)的一种补充性非药物干预措施,正受到越来越多的关注。这项初步研究主要旨在量化运动症状对交替运动方式的个体反应模式,以及非运动功能和神经可塑性与神经退行性变的血液生物标志物。 材料与方法:帕金森病患者采用交叉单病例实验设计进行高强度间歇训练(HIIT)和持续有氧运动(CAE)。对结果指标进行了重复评估。结果指标的轨迹在时间序列图中可视化,并相对于最小临床重要差异(MCID)和最小可检测变化(SDC)进行解释,或使用趋势线解释为正向或负向变化。 结果:分析了三名参与者的数据,进行体育锻炼似乎有助于减轻运动症状。参与者1的运动功能有所改善,与运动方式无关;而对于参与者2,仅在进行CAE时观察到运动功能出现这种具有临床意义的(正向)变化。参与者3在进行HIIT后运动功能有所改善,但由于退出研究,无法与CAE进行比较。在次要结果指标上发现了异质性反应,不仅在运动方式之间,而且在参与者之间。 结论:尽管这项研究证实了体育锻炼对帕金森病管理的积极影响,但参与者对干预措施的个体反应模式存在很大差异,这使得难以确定运动引起的功能和血液生物标志物的明确适应性变化。需要进一步的研究来克服测量个体反应模式方面的方法学挑战。
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