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LSVT® BIG 对比通过同步远程康复进行的帕金森病渐进式结构化运动训练:一项随机对照试验。

LSVT® BIG versus progressive structured mobility training through synchronous telerehabilitation in Parkinson's disease: A randomized controlled trial.

机构信息

Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Biruni University, Istanbul, Turkey.

Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey.

出版信息

Neurol Sci. 2024 Jul;45(7):3163-3172. doi: 10.1007/s10072-024-07322-0. Epub 2024 Jan 25.

Abstract

BACKGROUND

Parkinson's disease (PD) is a common neurodegenerative illness associated with motor symptoms.

AIM

The aim of study was to compare the effects of synchronous telerehabilitation-based Lee Silverman Voice Treatment® BIG (LSVT® BIG) protocol and progressive structured mobility training in patients with Parkinson's disease (PD).

METHODS

Thirty-two patients diagnosed with PD (aged 40-72 years, Hoehn-Yahr stage 1-3) were randomly allocated into LSVT® BIG (Group 1) and Progressive Structured Mobility Training (Group 2) groups. Exercises were performed in both groups for 60 min a day, 4 days a week, for 4 weeks under the supervision of a physiotherapist with synchronous online videoconference method. Dynamic balance was assessed with Mini-Balance Evaluation Systems Test (Mini-BESTest) as a primary outcome measure. The secondary outcome measurements were Timed Up and Go Test (TUG), spatiotemporal parameters of gait from Kinovea® software, and postural stability from the Biodex Balance System. Other outcome measures were Activity-Specific Balance Confidence Scale-Short Form (ABC-SF), Parkinson's Activity Scale (PAS), and Parkinson's Disease Quality of Life Questionnaire (PDQ-39).

RESULTS

This study showed significant group-by-time interactions on Mini-BEST (p = 0.042), ABC-SF (p = 0.029), and PAS (p = 0.022) in favor of group 1. Also, TUG (p < 0.01), spatiotemporal parameters of gait (p < 0.01), and PDQ-39 (p < 0.01) were improved in both groups.

CONCLUSION

Both synchronous telerehabilitation-based exercise protocols enhanced balance and gait, as well as activity level and quality of life in patients with PD. LSVT® BIG may be preferred to improve dynamic balance, balance confidence, and activity status in the early stages of PD. These results should be confirmed in future studies with more robust methodology.

TRIAL REGISTRATION

NCT04694872.

摘要

背景

帕金森病(PD)是一种常见的神经退行性疾病,与运动症状有关。

目的

本研究旨在比较基于同步远程康复的 Lee Silverman 嗓音治疗® BIG(LSVT® BIG)方案与渐进式结构化运动训练对帕金森病(PD)患者的疗效。

方法

32 名被诊断为 PD(年龄 40-72 岁,Hoehn-Yahr 分期 1-3)的患者被随机分配到 LSVT® BIG(第 1 组)和渐进式结构化运动训练(第 2 组)。两组患者均由物理治疗师在同步在线视频会议方法的监督下,每天进行 60 分钟、每周 4 天、持续 4 周的运动。动态平衡采用 Mini-Balance Evaluation Systems Test(Mini-BESTest)作为主要观察指标进行评估。次要观察指标包括计时起立行走测试(TUG)、Kinovea®软件记录的步态时空参数和 Biodex 平衡系统的姿势稳定性。其他观察指标包括活动特异性平衡信心量表-短表(ABC-SF)、帕金森病活动量表(PAS)和帕金森病生活质量问卷(PDQ-39)。

结果

本研究显示,Mini-BEST(p=0.042)、ABC-SF(p=0.029)和 PAS(p=0.022)的组间时间交互作用有统计学意义,第 1 组更具优势。同时,TUG(p<0.01)、步态时空参数(p<0.01)和 PDQ-39(p<0.01)在两组中均得到改善。

结论

基于同步远程康复的两种运动方案均能提高 PD 患者的平衡和步态能力,以及活动水平和生活质量。LSVT® BIG 可能更适合于改善 PD 早期的动态平衡、平衡信心和活动状态。这些结果需要更严格的方法学在未来的研究中进行验证。

试验注册

NCT04694872。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a295/11176092/ccc95c3c9779/10072_2024_7322_Fig1_HTML.jpg

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