Paris Brain Institute, CNRS UMR 7225, INSERM 1127, Sorbonne University, Paris, France.
LabCom Brain e-Novation, Paris Brain Institute, Paris, France.
Eur J Neurol. 2024 Jan;31(1):e16055. doi: 10.1111/ene.16055. Epub 2023 Sep 10.
Exergaming has been proposed to improve gait and balance disorders in Parkinson's disease (PD) patients. We aimed to assess the efficacy of a home-based, tailored, exergaming training system designed for PD patients with dopa-resistant gait and/or balance disorders in a controlled randomized trial.
We recruited PD patients with dopa-resistant gait and/or balance disorders. Patients were randomly assigned (1:1 ratio) to receive 18 training sessions at home by playing a tailored exergame with full-body movements using a motion capture system (Active group), or by playing the same game with the computer's keyboard (Control group). The primary endpoint was the between-group difference in the Stand-Walk-Sit Test (SWST) duration change after training. Secondary outcomes included parkinsonian clinical scales, gait recordings, and safety.
Fifty PD patients were enrolled and randomized. After training, no significant difference in SWST change was found between groups (mean change SWST duration [SD] -3.71 [18.06] s after Active versus -0.71 [3.41] s after Control training, p = 0.61). Some 32% of patients in the Active and 8% in the Control group were considered responders to the training program (e.g., SWST duration change ≥2 s, p = 0.03). The clinical severity of gait and balance disorders also significantly decreased after Active training, with a between-group difference in favor of the Active training (p = 0.0082). Home-based training induced no serious adverse events.
Home-based training using a tailored exergame can be performed safely by PD patients and could improve gait and balance disorders. Future research is needed to investigate the potential of exergaming.
电子游戏已被提议用于改善帕金森病（PD）患者的步态和平衡障碍。我们旨在评估一种针对 PD 患者的基于家庭的、定制的、全身运动的电子游戏训练系统的疗效，该系统适用于对多巴胺药物无反应的步态和/或平衡障碍患者，这是一项对照随机试验。
我们招募了对多巴胺药物无反应的步态和/或平衡障碍的 PD 患者。患者被随机分配（1:1 比例）在家中接受 18 次训练，方法是使用运动捕捉系统进行全身运动的定制电子游戏（主动组），或使用计算机键盘进行相同的游戏（对照组）。主要终点是训练后站立-行走-坐下测试（SWST）持续时间变化的组间差异。次要结果包括帕金森临床量表、步态记录和安全性。
共纳入并随机分配了 50 名 PD 患者。训练后，两组之间 SWST 变化无显著差异（主动训练后 SWST 持续时间的平均变化[SD]为-3.71[18.06]s，而对照组为-0.71[3.41]s，p=0.61）。主动组中有 32%的患者和对照组中有 8%的患者被认为对训练方案有反应（例如，SWST 持续时间变化≥2s，p=0.03）。主动训练后，步态和平衡障碍的临床严重程度也显著降低，主动训练组有明显的组间差异（p=0.0082）。家庭训练没有引起严重的不良事件。
PD 患者可以安全地进行基于家庭的定制电子游戏训练，可以改善步态和平衡障碍。需要进一步研究来探索电子游戏的潜力。
