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正念引导疗法能否成为帕金森病患者康复的新方向:基于运动/感觉的非药物替代干预措施的网状Meta分析

Whether mindfulness-guided therapy can be a new direction for the rehabilitation of patients with Parkinson's disease: a network meta-analysis of non-pharmacological alternative motor-/sensory-based interventions.

作者信息

He Shenglan, Fang Wanyi, Wu Jiaoyang, Lv Hang, Zhang Jueyu, Wang Tunyi, Huang Yingjie, Li Guangyao, Li Min

机构信息

Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.

The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Front Psychol. 2023 Sep 14;14:1162574. doi: 10.3389/fpsyg.2023.1162574. eCollection 2023.


DOI:10.3389/fpsyg.2023.1162574
PMID:37780170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10540073/
Abstract

BACKGROUND: The treatment for Parkinson's disease (PD) consumes a lot of manpower and financial resources. Non-pharmacological alternative motor-/sensory-based interventions are optimized for the rehabilitation of PD patients. Mindfulness-based therapy shows ideal efficacy, but the diversity of the therapy brings difficulties to the selection of clinicians and patients. METHODS: Network meta-analysis in the Bayesian framework was used to evaluate the efficacy of non-pharmacological alternative motor-/sensory-based interventions in improving motor and non-motor symptoms in PD patients. RESULTS: A total of 58 studies (2,227 patients) were included. Compared with the non-intervention group, qigong was associated with improved outcomes in the Timed Up and Go (TUG) test (mean difference (MD) -5.54, 95% confidence interval (CI) -8.28 to -2.77), and UPDRS-I (MD -15.50, 95% CI -19.93 to -7.63). Differences between non-pharmacological alternative motor-/sensory-based interventions were not significant for PDQ-39, UPDRS-I, or UPDRS-II; however, qigong was superior to dance (MD -3.91, 95% CI -6.90 to -0.95), Tai Chi (MD -3.54, 95% CI -6.53 to -0.69), acupuncture (MD -6.75, 95% CI -10.86 to -2.70), music (MD -3.91, 95% CI -7.49 to -0.48), and exercise (MD -3.91, 95% CI -6.49 to -1.33) in the TUG test. CONCLUSION: This network meta-analysis supports mindfulness-based therapy (e.g., qigong, yoga, and Tai Chi) as a preferred non-pharmacological alternative motor-/sensory-based intervention for PD rehabilitation. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2022-10-0109/, INPLASY2022100109.

摘要

背景:帕金森病(PD)的治疗耗费大量人力和财力。基于运动/感觉的非药物替代干预措施针对PD患者的康复进行了优化。基于正念的疗法显示出理想的疗效,但该疗法的多样性给临床医生和患者的选择带来了困难。 方法:采用贝叶斯框架下的网络荟萃分析来评估基于运动/感觉的非药物替代干预措施对改善PD患者运动和非运动症状的疗效。 结果:共纳入58项研究(2227例患者)。与非干预组相比,气功在定时起立行走测试(TUG)(平均差(MD)-5.54,95%置信区间(CI)-8.28至-2.77)和统一帕金森病评定量表第一部分(UPDRS-I)(MD -15.50,95% CI -19.93至-7.63)方面与更好的结果相关。基于运动/感觉的非药物替代干预措施在帕金森病问卷39项(PDQ-39)、UPDRS-I或UPDRS-II方面的差异不显著;然而,在TUG测试中,气功优于舞蹈(MD -3.91,95% CI -6.90至-0.95)、太极拳(MD -3.54,95% CI -6.53至-0.69)、针灸(MD -6.75,95% CI -10.86至-2.70)、音乐(MD -3.91,95% CI -7.49至-0.48)和运动(MD -3.91,95% CI -6.49至-1.33)。 结论:这项网络荟萃分析支持基于正念的疗法(如气功、瑜伽和太极拳)作为PD康复首选的基于运动/感觉的非药物替代干预措施。 系统评价注册:https://inplasy.com/inplasy-2022-10-0109/,INPLASY2022100109。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/72c3a0110ea1/fpsyg-14-1162574-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/b47eab01cf92/fpsyg-14-1162574-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/08a244aa0e91/fpsyg-14-1162574-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/a28efd758431/fpsyg-14-1162574-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/72c3a0110ea1/fpsyg-14-1162574-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/b47eab01cf92/fpsyg-14-1162574-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/08a244aa0e91/fpsyg-14-1162574-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/a28efd758431/fpsyg-14-1162574-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cb8/10540073/72c3a0110ea1/fpsyg-14-1162574-g004.jpg

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引用本文的文献

[1]
Precision medicine and music therapy for Parkinson's Disease.

Clin Park Relat Disord. 2025-8-6

[2]
Tai Chi improves balance, mobility and gait function of the lower limbs in patients with Parkinson's disease: a systematic review and meta-analysis.

Eur J Med Res. 2025-2-17

[3]
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Front Neurol. 2025-1-3

[4]
Quality assessment and umbrella review of systematic reviews about dance for people with Parkinson's disease.

PLoS One. 2024-12-31

[5]
The effects of Baduanjin on fine motor skills in mild and moderate Parkinson's disease: A randomized controlled trial.

Clin Park Relat Disord. 2024-10-16

[6]
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Am J Transl Res. 2024-6-15

本文引用的文献

[1]
Effectiveness of Acupuncture for Anxiety Among Patients With Parkinson Disease: A Randomized Clinical Trial.

JAMA Netw Open. 2022-9-1

[2]
Effects of mind-body exercises on cognitive impairment in people with Parkinson's disease: A mini-review.

Front Neurol. 2022-9-1

[3]
Comparison of Wuqinxi Qigong with Stretching on Single- and Dual-Task Gait, Motor Symptoms and Quality of Life in Parkinson's Disease: A Preliminary Randomized Control Study.

Int J Environ Res Public Health. 2022-6-30

[4]
Hatha yoga training improves standing balance but not gait in Parkinson's disease.

Sports Med Health Sci. 2020-5-23

[5]
Effects of Ten Different Exercise Interventions on Motor Function in Parkinson's Disease Patients-A Network Meta-Analysis of Randomized Controlled Trials.

Brain Sci. 2022-5-27

[6]
Effects of tai chi and Qigong on cognition in neurological disorders: A systematic review and meta-analysis.

Geriatr Nurs. 2022

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Targeting gut-brain axis through scalp-abdominal electroacupuncture in Parkinson's disease.

Brain Res. 2022-9-1

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Ann Behav Med. 2022-10-3

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Effects of Health Qigong Exercise on Lower Limb Motor Function in Parkinson's Disease.

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