He Shenglan, Fang Wanyi, Wu Jiaoyang, Lv Hang, Zhang Jueyu, Wang Tunyi, Huang Yingjie, Li Guangyao, Li Min
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.
Front Psychol. 2023 Sep 14;14:1162574. doi: 10.3389/fpsyg.2023.1162574. eCollection 2023.
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.
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。
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