Pinto Camila, Simon Myra Rafaela, Severo do Pinho Alexandre, Pereira Francisca, Orgs Guido, Pagnussat Aline Souza
Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
PLoS One. 2024 Dec 31;19(12):e0311003. doi: 10.1371/journal.pone.0311003. eCollection 2024.
OBJECTIVE(S): To determine (1) the quality of systematic reviews about dance-based intervention in individuals with Parkinson's disease (PD) and (2) standard evidence for dance-based intervention efficacy based on the categories of The International Classification of Functioning, Disability, and Health (ICF) from the World Health Organization's (WHO).
The data source included MEDLINE, PUBMED, Embase, Scopus, CENTRAL (Cochrane Library), CINAHL, PEDro, SPORTDiscus, APA PsycNet (APA PsycINFO), LILACS, SciELO, and AMED. Pairs of independent reviewers screened titles, abstracts, and full texts of eligible studies by using the software Covidence. Criteria included: systematic review designs; individuals with PD; dance-based interventions aimed to change critical PD symptoms matched to IFC domains (body functions, activities, and participation). Independent reviewers extracted information regarding the characteristics of all systematic reviews included and appraised quality using A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2). Randomized controlled trials and their risk of bias were identified within each review and were used to perform an updated pairwise meta-analysis.
Of the 571 manuscripts screened, 55 reviews met the inclusion criteria. The overall confidence in the results of 38 reviews (69%) was rated as 'critically low,' nine (9%) as 'low,' one (2%) as 'moderate,' while seven of 55 reviews (13%) were rated as 'high'. Dance associated with pharmacological usual care is better than pharmacological usual care alone for essential components of ICF, such as motor symptoms severity (body function), depressive symptoms (body function), balance (body function and activity), and functional mobility (activity), but not for gait distance (activity) and quality of life (participation). Dance is also superior to multimodal exercise to improve balance.
Clinicians and people with PD can refer to this paper for a summary of high-quality reviews and the overall evidence supporting dance as an adjunct rehabilitation. This umbrella review not only underscores the therapeutic potential of dance but also reinforces the use of arts-based approaches into healthcare practices for people with neurological conditions.
(1) 确定关于帕金森病（PD）患者基于舞蹈的干预措施的系统评价质量；(2) 根据世界卫生组织（WHO）的《国际功能、残疾和健康分类》（ICF）类别，确定基于舞蹈的干预效果的标准证据。
数据来源包括MEDLINE、PUBMED、Embase、Scopus、CENTRAL（Cochrane图书馆）、CINAHL、PEDro、SPORTDiscus、APA PsycNet（APA PsycINFO）、LILACS、SciELO和AMED。由两名独立评审员使用Covidence软件筛选符合条件的研究的标题、摘要和全文。标准包括：系统评价设计；PD患者；旨在改变与IFC领域（身体功能、活动和参与）相匹配的关键PD症状的基于舞蹈的干预措施。独立评审员提取了所有纳入的系统评价的特征信息，并使用评估系统评价的测量工具（AMSTAR 2）评估质量。在每项评价中识别随机对照试验及其偏倚风险，并用于进行更新的成对荟萃分析。
在筛选的571篇手稿中，55篇评价符合纳入标准。38篇评价（69%）的结果总体可信度被评为“极低”，9篇（9%）为“低”，1篇（2%）为“中等”，而55篇评价中有7篇（13%）被评为“高”。对于ICF的基本组成部分，如运动症状严重程度（身体功能）、抑郁症状（身体功能）、平衡（身体功能和活动）和功能移动性（活动），与药物常规治疗相关的舞蹈比单独的药物常规治疗更好，但对于步幅距离（活动）和生活质量（参与）则不然。舞蹈在改善平衡方面也优于多模式运动。
临床医生和PD患者可以参考本文，以获取高质量评价的总结以及支持舞蹈作为辅助康复手段的总体证据。这项综合评价不仅强调了舞蹈的治疗潜力，还加强了将基于艺术的方法应用于神经系统疾病患者的医疗保健实践中。
