Souza Rogério José de, Shigaki Isabela Andrelino de Almeida, Terra Marcelle Brandão, Barboza Natália Mariano, Bueno Maria Eduarda Brandão, Mesas Arthur Eumann, Smaili Suhaila Mahmoud
Department of Physiotherapy, Londrina State University (UEL), Londrina, Paraná, Brazil.
Centro de Estudios Sociosanitario, Universidad de Castilla-La Mancha, Cuenca, Cuenca, Spain.
Sleep Sci. 2023 Jul 6;16(2):206-215. doi: 10.1055/s-0043-1770801. eCollection 2023 Jun.
Sleep disorders are disabling and highly prevalent comorbidities in Parkinson's disease (PD). This study's objective was to verify the effectiveness of neurofunctional physiotherapy in sleep quality, objectively and subjectively assessing it among individuals with PD. A sample of individuals with PD was assessed before and after 32 physiotherapy sessions and three months later (follow-up). The following instruments were used: Pittsburgh Sleep Quality Index (PSQI); Epworth Sleepiness Scale (ESS); Parkinson's Disease Sleep Scale (PDSS), and actigraphy. Nineteen individuals aged 67.37 years old ( ± 8.03) on average were included. No differences were found in any of the variables measured by the actigraphy or the ESS. Improvement was found from pre- to post-intervention in terms of nocturnal movements (p = 0.04; d = 0.46) and total score (p = 0.03; d = 0.53) obtained on the PDSS. Improvement was also found in the PDSS sleep onset/maintenance domain (p = 0.001; d = 0.75) between pre-intervention and follow-up. The participants' total score obtained in the PSQI improved from pre- to post-intervention (p = 0.03; d = 0.44). Significant differences were found in nighttime sleep (p = 0.02; d = 0.51) and nocturnal movements (p = 0.02; d = 0.55), and in the PDSS total score (p = 0.04; d = 0.63) between pre- and post-intervention when only the poor sleepers subgroup (n = 13) was considered, while improvements were found in sleep onset/maintenance (p = 0.003; d = 0.91) between pre-intervention and follow-up. Neurofunctional physiotherapy was ineffective in improving objective parameters of sleep but was effective in improving the perception of sleep quality subjectively assessed among individuals with PD, especially those who perceived themselves to be poor sleepers.
睡眠障碍是帕金森病（PD）中使人致残且极为常见的合并症。本研究的目的是验证神经功能物理治疗对睡眠质量的有效性，并对PD患者的睡眠质量进行客观和主观评估。
对一组PD患者在32次物理治疗前后以及三个月后（随访）进行了评估。使用了以下工具：匹兹堡睡眠质量指数（PSQI）；爱泼华嗜睡量表（ESS）；帕金森病睡眠量表（PDSS）以及活动记录仪。
平均纳入了19名年龄为67.37岁（±8.03）的患者。活动记录仪或ESS所测量的任何变量均未发现差异。在PDSS所获得的夜间活动（p = 0.04；d = 0.46）和总分（p = 0.03；d = 0.53）方面，干预前后有改善。干预前和随访之间，PDSS睡眠起始/维持领域也有改善（p = 0.001；d = 0.75）。参与者在PSQI中获得的总分干预前后有所改善（p = 0.03；d = 0.44）。仅考虑睡眠不佳亚组（n = 13）时，干预前后在夜间睡眠（p = 0.02；d = 0.51）和夜间活动（p = 0.02；d = 0.55）以及PDSS总分（p = 0.04；d = 0.63）方面发现有显著差异，而干预前和随访之间在睡眠起始/维持方面有改善（p = 0.003；d = 0.91）。
神经功能物理治疗在改善睡眠客观参数方面无效，但在改善PD患者主观评估的睡眠质量感知方面有效，尤其是那些自认为睡眠不佳的患者。
