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可穿戴提示设备对帕金森病步态和运动功能的疗效:随机对照试验的系统评价和荟萃分析

The Efficacy of Wearable Cueing Devices on Gait and Motor Function in Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

作者信息

Zhang Tian, Meng De-Tao, Lyu Di-Yang, Fang Bo-Yan

机构信息

Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.

Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.

出版信息

Arch Phys Med Rehabil. 2024 Feb;105(2):369-380. doi: 10.1016/j.apmr.2023.07.007. Epub 2023 Aug 1.

Abstract

OBJECTIVE

To summarize the efficacy of wearable cueing devices for improving gait and motor function of patients with Parkinson disease (PWP).

DATA SOURCES

PubMed, Embase, and Cochrane CENTRAL databases were searched for papers published in English, from inception to October 23, 2022.

STUDY SELECTION

Randomized controlled trials focusing on the effects of wearable cueing devices on gait and motor function in PWP were included.

DATA EXTRACTION

Two reviewers independently selected articles and extracted the data. The Cochrane Bias Risk Assessment Tool was used to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of evidence.

DATA SYNTHESIS

Seven randomized controlled trials with 167 PWP were included in the meta-analysis. Significant effect of wearable cueing devices on walking speed (mean difference [MD]=0.07 m/s, 95% confidence interval [CI]: [0.05, 0.09], P<.00001) was detected; however, after sensitivity analysis, no significant overall effect on walking speed was noted (MD=0.04 m/s, 95% CI: [-0.03, 0.12], P=.25). No significant improvements were found in stride length (MD=0.06 m, 95% CI: [0.00, 0.13], P=.05), the Unified Parkinson's Disease Rating Scale-III score (MD=-0.61, 95% CI: [-4.10, 2.88], P=.73), Freezing of Gait Questionnaire score (MD=-0.83, 95% CI: [-2.98, 1.33], P=.45), or double support time (MD=-0.91, 95% CI: [-3.09, 1.26], P=.41). Evidence was evaluated as low quality.

CONCLUSIONS

Wearable cueing devices may result in an immediate improvement on walking speed; however, there is no evidence that their use results in a significant improvement in other gait or motor functions.

摘要

目的

总结可穿戴提示装置改善帕金森病患者(PWP)步态和运动功能的疗效。

数据来源

检索PubMed、Embase和Cochrane CENTRAL数据库中自数据库建立至2022年10月23日发表的英文论文。

研究选择

纳入聚焦可穿戴提示装置对PWP步态和运动功能影响的随机对照试验。

数据提取

两名研究者独立筛选文章并提取数据。采用Cochrane偏倚风险评估工具评估偏倚风险,采用推荐分级的评估、制定与评价工具评估证据质量。

数据合成

荟萃分析纳入7项随机对照试验中的167例PWP。检测到可穿戴提示装置对步行速度有显著影响(平均差值[MD]=0.07 m/s,95%置信区间[CI]:[0.05, 0.09],P<0.00001);然而,敏感性分析后,未观察到对步行速度有显著总体影响(MD=0.04 m/s,95% CI:[-0.03, 0.12],P=0.25)。步幅(MD=0.06 m,95% CI:[0.00, 0.13],P=0.05)、统一帕金森病评定量表III评分(MD=-0.61,95% CI:[-4.10, 2.88],P=0.73)、步态冻结问卷评分(MD=-0.83,95% CI:[-2.98, 1.33],P=0.45)或双支撑时间(MD=-0.91,95% CI:[-3.09, 1.26],P=0.41)均未发现显著改善。证据质量评估为低质量。

结论

可穿戴提示装置可能会使步行速度立即得到改善;然而,没有证据表明使用这些装置能显著改善其他步态或运动功能。

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