Moura Loureiro Ricardo Filipe de, Santana Elaine Dos Santos, Duque Filipa Margarida Gonçalves, Bernardes Rafael Alves, Ventura Filipa Isabel Quaresma, Silva Rosa Carla Gomes da, Oliveira Albertina Lima de, Lima Margarida Pedroso de, Almeida Maria de Lurdes Ferreira de, Cardoso Daniela Filipa Batista, Cardoso Ana Filipa Dos Reis Marques
The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
University of Coimbra, Coimbra, Portugal.
JBI Evid Synth. 2025 Jul 1;23(7):1308-1375. doi: 10.11124/JBIES-24-00183. Epub 2025 May 22.
The objective of this review was to map the characteristics of respiratory rehabilitation programs for people with Parkinson's disease.
Parkinson's disease is a progressive and heterogeneous neurodegenerative disease. Respiratory dysfunction is highly prevalent in people with Parkinson's disease and is a major contributor to morbidity and mortality. People with Parkinson's disease may experience respiratory dysfunction such as ineffective coughing and dyspnea. Complications, such as atelectasis and respiratory infections, significantly impact their self-care and quality of life. To mitigate its impact on people's lives, various respiratory rehabilitation programs have been developed and implemented. Many studies have examined this topic, yet respiratory rehabilitation programs vary significantly in structure and evaluated outcomes.
We considered studies focused on respiratory rehabilitation programs implemented to prevent or target one or more symptoms for adults (18 years and older) with Parkinson's disease, regardless of the disease stage. The programs could be provided by any health professional in any health care setting.
We followed JBI methodology for conducting the scoping review, and the results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A literature search was conducted across PubMed, CINAHL Complete (EBSCOhost), Cochrane Central Register of Controlled Trials (EBSCOhost), the Cochrane Database of Systematic Reviews (EBSCOhost), Scielo, Scopus, PEDro, and ClinicalTrials.gov. Unpublished studies were identified via Google Scholar, DART-Europe, and MedNar. All search strategies were conducted on April 24, 2023. Sources published in English, Spanish, and Portuguese were included and no date restrictions were applied. Study selection and data extraction were conducted independently by 2 reviewers using a standardized extraction tool.
Thirty-three studies published between 2001 and 2023 were included. Studies were conducted in the USA, Brazil, Turkey, Chile, Australia, Taiwan, Czechia, Italy, Republic of Korea, Germany, India, and Israel. The sample sizes ranged from 1 participant to 75 participants. The combined sample size of all studies was 1007 participants. Most programs integrated respiratory muscle strength training using devices, targeting people with Parkinson´s disease in Hoehn and Yahr scale stages 1-3. Speech-language pathologists, physiotherapists, and medical doctors were the health professionals responsible for delivering these programs in home-based or clinical settings. A broad spectrum of outcomes related to respiratory function was reported. Additionally, the studies assessed other outcomes such as quality of life, functional capacity, motor symptoms, and fatigue.
Respiratory rehabilitation programs for people with Parkinson's disease have predominantly targeted respiratory muscle strength training, without a multidisciplinary approach. More research is needed emphasizing inclusive studies in terms of exercises/interventions in respiratory rehabilitation programs, stages of disease progression, and with the adoption of a multidisciplinary approach.
OSF https://osf.io/hgajt.
A translation of the abstract of this review is available in Portuguese at http://links.lww.com/SRX/A107 .
本综述的目的是梳理帕金森病患者呼吸康复计划的特点。
帕金森病是一种进行性、异质性神经退行性疾病。呼吸功能障碍在帕金森病患者中非常普遍，是发病和死亡的主要原因。帕金森病患者可能会出现呼吸功能障碍，如无效咳嗽和呼吸困难。诸如肺不张和呼吸道感染等并发症会显著影响他们的自我护理和生活质量。为减轻其对人们生活的影响，已制定并实施了各种呼吸康复计划。许多研究都探讨了这个话题，但呼吸康复计划在结构和评估结果方面差异很大。
我们纳入了专注于为18岁及以上帕金森病成人实施的、旨在预防或针对一种或多种症状的呼吸康复计划的研究，无论疾病处于何阶段。该计划可由任何医疗保健机构的任何卫生专业人员提供。
我们遵循循证卫生保健合作中心（JBI）的方法进行范围综述，并根据系统评价与Meta分析扩展版范围综述的首选报告项目（PRISMA-ScR）报告结果。在PubMed、CINAHL Complete（EBSCOhost）、Cochrane对照试验中央注册库（EBSCOhost）、Cochrane系统评价数据库（EBSCOhost）、Scielo、Scopus、PEDro和ClinicalTrials.gov上进行了文献检索。通过谷歌学术、欧洲文献传递服务（DART-Europe）和医学文摘数据库（MedNar）识别未发表的研究。所有检索策略均在2023年4月24日进行。纳入了以英文、西班牙文和葡萄牙文发表的文献，且不设日期限制。由两名评审员使用标准化提取工具独立进行研究筛选和数据提取。
纳入了2001年至2023年间发表的33项研究。这些研究在美国、巴西、土耳其、智利、澳大利亚、台湾、捷克、意大利、韩国、德国、印度和以色列进行。样本量从1名参与者到75名参与者不等。所有研究的合并样本量为1007名参与者。大多数计划采用设备进行呼吸肌力量训练，针对Hoehn和Yahr分期1-3期的帕金森病患者。言语治疗师、物理治疗师和医生是在家庭或临床环境中负责实施这些计划的卫生专业人员。报告了与呼吸功能相关的广泛结果。此外，这些研究还评估了其他结果，如生活质量、功能能力、运动症状和疲劳。
针对帕金森病患者的呼吸康复计划主要侧重于呼吸肌力量训练，缺乏多学科方法。需要更多的研究，强调在呼吸康复计划的运动/干预、疾病进展阶段以及采用多学科方法方面进行包容性研究。
开放科学框架（OSF）https://osf.io/hgajt 。
本综述摘要的葡萄牙语翻译可在http://links.lww.com/SRX/A107 获得。
