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基于欧洲指南核心领域的基于运动游戏的方案和传统物理治疗同样改善帕金森病患者的步态和认知:随机临床试验

Exergame-Based Program and Conventional Physiotherapy Based on Core Areas of the European Guideline Similarly Improve Gait and Cognition in People with Parkinson's Disease: Randomized Clinical Trial.

作者信息

Nuvolini Rosemeyre Alcarde, Silva Keyte Guedes Da, Freitas Tatiana Beline De, Doná Flávia, Torriani-Pasin Camila, Pompeu José Eduardo

机构信息

Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.

Laboratory of Motor Behavior, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.

出版信息

Games Health J. 2025 Mar 31. doi: 10.1089/g4h.2024.0116.

Abstract

Gait impairments are among the most common and disabling symptoms of Parkinson's disease and are especially aggravated in dual-task conditions. Interventions with conventional physical therapy improve gait cadence and speed, cognition, fear of falling, and freezing of gait. However, exergames have attracted interest in the treatment of people with Parkinson's disease due to the characteristics of the training that benefit neuroplasticity and motor learning. The aim of this study was to analyze the effects of training based on Kinect exergames compared to conventional physiotherapeutic training based on core areas of the European physiotherapy guideline on functional mobility, gait, and cognitive functions. Thirty-eight people with idiopathic Parkinson's disease were randomized into two groups and underwent 14 intervention sessions, twice a week, for 60 minutes each. The primary outcome was postural stability in gait, which was evaluated using the Functional Gait Assessment. Secondary outcomes were functional mobility and impact of the dual task assessed using the Timed & Up and Go Test; gait speed by the 10-meter Walk Test in single and dual task; and cognitive functions assessed through the Montreal Cognitive Assessment. After training, there was an improvement in the Functional Gait Assessment and Timed & Up and Go Test. Interventions based on Kinect AdventuresTM games and conventional physiotherapy based on the central areas of the European guideline promoted similar improvements in gait stability and functional mobility of people with Parkinson's disease, without differences between them. However, the benefits did not extend to cognitive function and other gait parameters.

摘要

步态障碍是帕金森病最常见且致残的症状之一,在双重任务条件下会尤其加重。传统物理治疗干预可改善步频、速度、认知、跌倒恐惧和步态冻结。然而,由于训练特性有利于神经可塑性和运动学习,体感游戏已引起对帕金森病患者治疗的兴趣。本研究的目的是分析基于Kinect体感游戏的训练与基于欧洲物理治疗指南中功能移动性、步态和认知功能核心领域的传统物理治疗训练相比的效果。38名特发性帕金森病患者被随机分为两组,每周两次,每次60分钟,共进行14次干预疗程。主要结局是步态中的姿势稳定性,使用功能性步态评估进行评估。次要结局是使用定时起立行走测试评估的功能移动性和双重任务的影响;单任务和双重任务中通过10米步行测试评估的步态速度;以及通过蒙特利尔认知评估评估的认知功能。训练后,功能性步态评估和定时起立行走测试有所改善。基于Kinect AdventuresTM游戏的干预和基于欧洲指南核心领域的传统物理治疗在帕金森病患者的步态稳定性和功能移动性方面促进了相似的改善,两者之间没有差异。然而,这些益处并未扩展到认知功能和其他步态参数。

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