Sadek Alia T, Djerdjour Leila, Reyes Ryan A, Adams Greggory P, Logan Cara H, Smith Margaret A, Biddle Sara G, Wiles Timothy S, Urrea-Mendoza Enrique, McConnell Tracie M, Revilla Fredy J, Trilk Jennifer L
Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, 607 Grove Road, Greenville, SC, 29605, USA.
BioElectric Labs, Morganton, NC, USA.
Neurol Ther. 2024 Aug;13(4):1237-1257. doi: 10.1007/s40120-024-00636-3. Epub 2024 Jun 15.
Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health.
Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05.
Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04).
Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
帕金森病患者（PwPD）会出现运动和非运动症状，这些症状会显著影响他们的生活质量（QoL）以及其照护伙伴（CP）的生活质量。双人骑自行车可减轻PwPD的运动症状；然而，尚无研究考察其他益处或纳入PwPD的照护伙伴。我们开展了一项为期8周的社区虚拟现实（VR）双人骑自行车干预研究，以评估其对PwPD及其照护伙伴（即帕金森病二元组）的可行性和有效性。我们假设双人骑自行车将改善：（1）PwPD的运动和非运动症状；（2）帕金森病二元组的生活质量维度和生理健康状况。
招募了10个帕金森病二元组，以完成为期8周、强度递增、每两周一次的双人骑自行车活动。在测试前和测试后，使用运动障碍协会统一帕金森病评定量表第三部分（MDS-UPDRS-III）、功能性步态评估（FGA）和10米步态速度测试对PwPD进行评估。帕金森病二元组还完成了情绪和认知状态问卷[如老年抑郁量表简版（GDS-SF）]，并佩戴BodyGuard 2心率（HR）监测器48小时，以评估心率变异性的替代指标。使用学生t检验进行统计分析，显著性设定为p≤0.05。
8个帕金森病二元组和1名PwPD完成了干预。PwPD（90%）和照护伙伴（80%）的留存率良好，帕金森病二元组的依从率在91.67%至97.91%之间。PwPD在MDS-UPDRS-III评分（-7.38，p<0.01）、FGA评分（+3.50，p<0.01）和10米步态速度时间（+0.27米/秒，p<0.01）方面有显著的临床改善，此外，自我报告的活动能力（-13.61，p=0.02）、疲劳（-5.99，p=0.02）和社会参与度（+4.69，p<0.01）也有显著改善。照护伙伴的抑郁症状显著减轻（-0.88，p=0.02），帕金森病二元组的逐差均方根（RMSSD）显著增加（p=0.04）。
我们的初步研究证明了其可行性和多个方面的有效性，支持进一步研究将社区VR双人骑自行车作为帕金森病二元组的一种治疗干预措施。
