Universidad de Castilla La Mancha, Health and Social Research Center, Cuenca, Spain.
Universidad de Castilla La Mancha, Health and Social Research Center, Cuenca, Spain; Facultad de Ciencias de La Salud, Universidad Autónoma de Chile, Talca, Chile.
J Rehabil Med. 2024 Feb 1;56:jrm10329. doi: 10.2340/jrm.v56.10329.
OBJECTIVE: To assess which type of physical exercise intervention has the most beneficial effects on balance, postural stability and general mobility in patients with Parkinson's disease. These parameters were assessed using the Activities-specific Balance Confidence (ABC) scale, Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (MiniBESTest) and Timed Up and Go Test (TUG). DESIGN: Network meta-analysis. METHODS: The PubMed, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched up to August 2022 to identify randomized controlled trials on the effects of physical exercise interventions on balance, postural stability, and general mobility. The network meta-analysis included pairwise and indirect comparisons of results on the ABC scale, BBS, MiniBESTest, and TUG across 8 categories of physical exercise. RESULTS: Eighty-six studies with a total of 4,693 patients were included. For the ABC scale, the indirect comparison showed that the highest effect size was observed for balance vs sensorimotor training without including endurance interventions (0.62; 95% confidence interval (95% CI) 0.06, 1.17). The highest effect sizes for BBS were observed for alternative exercises (1.21; 95% CI 0.62, 1.81), body-weight supported (BWS) interventions (1.31; 95% CI 0.57, 2.05), dance (1.18; 95% CI 0.33, 2.03) and sensorimotor training, including endurance interventions (1.10; 95% CI 0.46, 1.75) vs control groups. Indirect comparisons showed that the highest effect size for the MiniBESTest were observed for balance (0.75; 95% CI 0.46, 1.04) and resistance (0.58; 95% CI 0.10, 1.07) vs control groups. For the TUG, comparisons showed a significant effect size for alternative exercises (-0.54; 95% CI -0.82, -0.26), balance (-0.42; 95% CI -0.75, -0.08), resistance (-0.60; 95% CI -0.89, -0.31), and sensorimotor training including endurance interventions (-0.61; 95% CI -0.95, -0.27) vs control comparisons. CONCLUSION: Balance interventions improve balance, postural stability, and general mobility in people with Parkinson's disease. Moreover, alternative exercises, dance, BWS interventions, resistance, and sensorimotor training, including and not including endurance interventions, are also effective.
目的：评估哪种类型的体育锻炼干预对帕金森病患者的平衡、姿势稳定性和整体移动能力最有益。使用活动特异性平衡信心（ABC）量表、伯格平衡量表（BBS）、简易平衡评估系统测试（MiniBESTest）和计时起立行走测试（TUG）来评估这些参数。
设计：网络荟萃分析。
方法：检索 PubMed、Cochrane 对照试验中心注册库和 Web of Science 数据库，截至 2022 年 8 月，以确定关于体育锻炼干预对平衡、姿势稳定性和整体移动能力影响的随机对照试验。网络荟萃分析包括对 8 类体育锻炼的 ABC 量表、BBS、MiniBESTest 和 TUG 结果的直接和间接比较。
结果：纳入 86 项研究，共 4693 名患者。对于 ABC 量表，间接比较显示，平衡与不包括耐力干预的感觉运动训练之间的效果最大（0.62；95%置信区间[95%CI]0.06，1.17）。BBS 的最高效果大小为交替运动（1.21；95%CI0.62，1.81）、体重支持（BWS）干预（1.31；95%CI0.57，2.05）、舞蹈（1.18；95%CI0.33，2.03）和感觉运动训练，包括耐力干预（1.10；95%CI0.46，1.75）与对照组。间接比较显示，MiniBESTest 的最高效果大小为平衡（0.75；95%CI0.46，1.04）和阻力（0.58；95%CI0.10，1.07）与对照组。对于 TUG，比较显示交替运动（-0.54；95%CI-0.82，-0.26）、平衡（-0.42；95%CI-0.75，-0.08）、阻力（-0.60；95%CI-0.89，-0.31）和感觉运动训练，包括耐力干预（-0.61；95%CI-0.95，-0.27）与对照组相比，具有显著的效果大小。
结论：平衡干预可改善帕金森病患者的平衡、姿势稳定性和整体移动能力。此外，交替运动、舞蹈、BWS 干预、阻力和感觉运动训练，包括和不包括耐力干预，也是有效的。
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