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带听觉提示的步行训练比单独的步行训练更能提高帕金森病患者的步行速度:系统评价。

Walking training with auditory cueing improves walking speed more than walking training alone in ambulatory people with Parkinson's disease: a systematic review.

机构信息

Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil.

Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Vitória, Brazil.

出版信息

J Physiother. 2024 Jul;70(3):208-215. doi: 10.1016/j.jphys.2024.06.004. Epub 2024 Jun 18.


DOI:10.1016/j.jphys.2024.06.004
PMID:38897907
Abstract

QUESTIONS: In people with Parkinson's disease, what is the effect of adding external cueing (ie, visual, auditory or somatosensorial cueing) to walking training compared with walking training alone in terms of walking, mobility, balance, fear of falling and freezing? Are any benefits carried over to participation or maintained beyond the intervention period? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Ambulatory adults with Parkinson's disease. INTERVENTION: Walking training with external cueing compared with walking training without external cueing. OUTCOME MEASURES: Walking (ie, speed, stride length and cadence), mobility, balance, fear of falling, freezing and participation. RESULTS: Ten trials involving a total of 309 participants were included. The mean PEDro score of the included trials was 5 (range 4 to 8). Walking training with auditory cueing improved walking speed by 0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone. Although the best estimate was that auditory cueing may also improve stride length by 5 cm, this estimate was imprecise (95% CI -2 to 11). The addition of visual cueing to walking training did not improve walking speed or stride length. Results regarding cadence, mobility, balance, fear of falling, and freezing and maintenance of benefits beyond the intervention period remain uncertain. CONCLUSION: This systematic review provided low-quality evidence that walking training with auditory cueing is more effective than walking training alone for improving walking speed in Parkinson's disease. Cueing is an inexpensive and easy to implement intervention, so the mean estimate might be considered clinically worthwhile, although the confidence interval spans clinically trivial and worthwhile effects. REGISTRATION: PROSPERO CRD42021255065.

摘要

问题:在帕金森病患者中,与单独进行行走训练相比,行走训练中加入外部提示(即视觉、听觉或体感提示)在行走、活动能力、平衡、跌倒恐惧和冻结方面有何效果?任何益处是否会持续到干预期之外或得到维持?

设计:随机试验的系统评价和荟萃分析。

参与者:有行走能力的帕金森病成年人。

干预:带外部提示的行走训练与不带外部提示的行走训练。

结局测量:行走(即速度、步长和步频)、活动能力、平衡、跌倒恐惧、冻结和参与度。

结果:纳入了 10 项共涉及 309 名参与者的试验。纳入试验的平均 PEDro 评分为 5 分(范围为 4 至 8 分)。与单独进行行走训练相比,带听觉提示的行走训练可使行走速度提高 0.09 米/秒(95%置信区间 0.02 至 0.15)。尽管最佳估计是听觉提示也可能使步长增加 5 厘米,但这一估计并不精确(95%置信区间-2 至 11)。将视觉提示加入行走训练并不能提高行走速度或步长。关于步频、活动能力、平衡、跌倒恐惧以及干预期后益处的维持,结果仍不确定。

结论:本系统评价提供了低质量证据,表明与单独进行行走训练相比,带听觉提示的行走训练更能有效提高帕金森病患者的行走速度。提示是一种廉价且易于实施的干预措施,因此,平均估计值可能被认为具有临床意义,但置信区间涵盖了临床微不足道和有意义的效果。

注册:PROSPERO CRD42021255065。

相似文献

[1]
Walking training with auditory cueing improves walking speed more than walking training alone in ambulatory people with Parkinson's disease: a systematic review.

J Physiother. 2024-7

[2]
Transcranial direct current stimulation provides no clinically important benefits over walking training for improving walking in Parkinson's disease: a systematic review.

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[3]
Model-based cueing-as-needed for walking in Parkinson's disease: A randomized cross-over study.

Rev Neurol (Paris). 2024-10

[4]
Walking training with cueing of cadence improves walking speed and stride length after stroke more than walking training alone: a systematic review.

J Physiother. 2014-12-17

[5]
A randomised controlled trial evaluating the effect of an individual auditory cueing device on freezing and gait speed in people with Parkinson's disease.

BMC Neurol. 2008-12-11

[6]
Effects of external rhythmical cueing on gait in patients with Parkinson's disease: a systematic review.

Clin Rehabil. 2005-10

[7]
Gait training with progressive external auditory cueing in persons with Parkinson's disease.

Arch Phys Med Rehabil. 2010-8

[8]
Treadmill training may be an effective form of task-specific training for improving mobility in people with Parkinson's disease and multiple sclerosis: a systematic review and meta-analysis.

Physiotherapy. 2018-11-15

[9]
The Efficacy of Wearable Cueing Devices on Gait and Motor Function in Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Arch Phys Med Rehabil. 2024-2

[10]
Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trial.

J Neurol Neurosurg Psychiatry. 2007-2

引用本文的文献

[1]
Status and influencing factors of balance in middle-aged and older adults with Parkinson's disease: a national longitudinal study.

Front Neurol. 2025-4-30

[2]
Harnessing Mirror Neurons: A New Frontier in Parkinson's Disease Rehabilitation-A Scoping Review of the Literature.

J Clin Med. 2024-8-2

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