Brown Jessy, Stegemöller Elizabeth L
Neuroscience and Gerontology Program, Department of Kinesiology, Iowa State University, Ames, IA, United States.
Front Rehabil Sci. 2024 Nov 21;5:1478490. doi: 10.3389/fresc.2024.1478490. eCollection 2024.
The purpose of this study was to understand how two respiratory strengthening protocols, therapeutic singing (TS) and expiratory muscle strength training (EMST), compare on measures of quality of life (QOL), depression and anxiety for persons with Parkinson's disease. An equally important aim was to understand participants' perceptions of both treatments.
Quantitative and qualitative datasets were integrated in a convergent mixed methods design within a randomized crossover intervention trial. Thirteen persons with mild-moderate PD (Hoehn and Yahr stage 1-3) completed both interventions, in random order, for 4 weeks, 5 days per week, for approximately 20 min per day. Participants completed self-report questionnaires (Geriatric Depression Scale, Parkinson's Anxiety Scale, Parkinson's Disease Questionnaire-39, and a Survey after Treatment) after each intervention, and twelve participants' qualitative data were analyzed.
Quantitative data did not reveal significant differences between the interventions in depression on the Geriatric Depression Scale or anxiety on the Parkinson's Anxiety Scale and the qualitative data support those findings. There were no significant differences between interventions in QOL as measured by the Parkinson's Disease Questionnaire-39, but there was a main effect of time, with a significant decline ( = 0.01) in perceived QOL between baseline and the final visit. The quantitative data diverged from the qualitative data as there were no themes that emerged to corroborate a decrease in QOL. Five qualitative themes were derived from thematic analysis: Benefits, Accessibility, Acceptability, Advice/Feedback, and Preference. Participants' perceptions of the interventions were closely aligned to individual differences and preferences, with an equal split of participants preferring TS and EMST.
Findings from this mixed methods comparison of two respiratory interventions will help to improve the acceptability and accessibility of the interventions to better facilitate adherence to the interventions and promote continued engagement, thereby delaying respiratory decline in those with PD.
本研究的目的是了解两种呼吸强化方案，即治疗性歌唱（TS）和呼气肌力量训练（EMST），在帕金森病患者的生活质量（QOL）、抑郁和焦虑测量方面的比较情况。一个同样重要的目标是了解参与者对这两种治疗方法的看法。
在一项随机交叉干预试验中，采用收敛性混合方法设计整合定量和定性数据集。13名轻度至中度帕金森病患者（Hoehn和Yahr分期1 - 3期）以随机顺序完成了两种干预，为期4周，每周5天，每天约20分钟。每次干预后，参与者完成自我报告问卷（老年抑郁量表、帕金森焦虑量表、帕金森病问卷 - 39以及治疗后调查），并对12名参与者的定性数据进行了分析。
定量数据未显示在老年抑郁量表上的抑郁或帕金森焦虑量表上的焦虑方面，两种干预之间存在显著差异，定性数据支持这些结果。帕金森病问卷 - 39测量的生活质量方面，两种干预之间没有显著差异，但存在时间的主效应，从基线到最后一次访视，感知生活质量有显著下降（= 0.01）。定量数据与定性数据存在分歧，因为没有出现证实生活质量下降的主题。通过主题分析得出了五个定性主题：益处、可及性、可接受性、建议/反馈和偏好。参与者对干预措施的看法与个体差异和偏好密切相关，偏好TS和EMST的参与者人数均等。
这两种呼吸干预措施的混合方法比较结果将有助于提高干预措施的可接受性和可及性，以更好地促进对干预措施的坚持并促进持续参与，从而延缓帕金森病患者的呼吸功能衰退。
