Clarkin Christine M, Ward-Ritacco Christie L, Mahler Leslie
Physical Therapy Department, University of Rhode Island, Kingston, Rhode Island, USA.
Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island, USA.
Rehabil Res Pract. 2024 Jan 19;2024:6188546. doi: 10.1155/2024/6188546. eCollection 2024.
The purpose of this study was to evaluate change in motor function, gait speed, dynamic balance, balance confidence, and quality of life (QoL) in nine participants with Parkinson's disease (PwPD) completing Lee Silverman Voice Treatment BIG (LSVT-BIG), an external cueing and task-based intervention. Although supported as an efficacious treatment in PwPD, there is limited research examining clinically meaningful change in outcome measures related to external cueing and task-based interventions.
This was a case series of nine PwPD (age range 64-76 years, 55% male) who completed the LSVT-BIG protocol. Disease duration ranged from 1 to 17 years and was classified as moderate in all participants (Hoehn and Yahr = 2 or 3). Outcome measures included motor function (MDS-UPDRS Part III Motor), gait speed, dynamic balance (MiniBEST), Activities-specific Balance Confidence (ABC), and Summary Index for PD Quality of Life 39 (PDQ-SI). Assessments were completed at baseline (BASE), end of treatment (EOT), and 4 weeks after EOT (EOT+4).
Minimal detectable change (MDC) or minimal clinical important difference (MCID) was observed in one or more outcome measures in 8 of 9 participants at EOT and EOT+4 across domains of motor function (67%, 78%), gait speed (78%, 67%), balance confidence (44%, 33%), quality of life (44%, 78%), and dynamic balance (22%, 22%). . In this case series, 8 of 9 participants showed MDC or MCID changes across multiple functional domains. Improvements were observed immediately post (EOT) and 4-week post-treatment (EOT+4) suggesting a temporal component of the LSVT-BIG impact on functional change. Future research should include clinical trials to examine additional external cueing and task-based intervention efficacy with consideration of intensity, frequency, and mode of delivery across disease severity.
本研究旨在评估9名帕金森病患者（PwPD）在完成李·西尔弗曼嗓音治疗强化版（LSVT-BIG）（一种外部提示和基于任务的干预）后运动功能、步速、动态平衡、平衡信心和生活质量（QoL）的变化。尽管LSVT-BIG被认为是治疗PwPD的有效方法，但关于与外部提示和基于任务的干预相关的结局指标中具有临床意义的变化的研究有限。
这是一个包含9名PwPD患者（年龄范围64 - 76岁，55%为男性）的病例系列，他们完成了LSVT-BIG方案。病程为1至17年，所有参与者均被分类为中度（Hoehn和Yahr分级 = 2或3）。结局指标包括运动功能（MDS-UPDRS第三部分运动功能）、步速、动态平衡（MiniBEST）、特定活动平衡信心（ABC）以及帕金森病生活质量39项汇总指数（PDQ-SI）。评估在基线（BASE）、治疗结束时（EOT）以及EOT后4周（EOT + 4）完成。
在EOT和EOT + 4时，9名参与者中有8名在运动功能（67%，78%）、步速（78%，67%）、平衡信心（44%，33%）、生活质量（44%，78%）和动态平衡（22%，22%）等领域的一项或多项结局指标中观察到最小可检测变化（MDC）或最小临床重要差异（MCID）。在这个病例系列中，9名参与者中有八名在多个功能领域显示出MDC或MCID变化。在治疗后即刻（EOT）和治疗后4周（EOT + 4）观察到改善，这表明LSVT-BIG对功能变化的影响具有时间因素。未来的研究应包括临床试验，以考虑疾病严重程度的强度、频率和实施方式，来检验额外的外部提示和基于任务的干预效果。
