跑步机训练用于轻度至中度帕金森病老年患者的步态康复：一项系统评价和荟萃分析。

Treadmill training for gait rehabilitation in elderly patients with mild-to-moderate Parkinson's disease: a systematic review and meta-analysis.

作者信息

Yin XiaoTing, Peng PeiQiang, Zhang HongXia, Hu JingYi, Wei YunHan, Li PinMei

机构信息

Department of Rehabilitation, Jilin University China-Japan Union Hospital, Changchun, China.

Department of Rehabilitation, Zhejiang Provincial People's Hospital, Hangzhou, China.

出版信息

Front Neurol. 2025 Jun 18;16:1609912. doi: 10.3389/fneur.2025.1609912. eCollection 2025.

DOI:10.3389/fneur.2025.1609912

PMID:40606144

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213742/

Abstract

BACKGROUND

Parkinson's disease (PD), the second most prevalent neurodegenerative disorder, leads to lower extremity dysfunction that critically contributes to falls and disability, yet effective rehabilitation remains limited.

OBJECTIVE

Systematic assessment of the effects of treadmill training on lower limb motor performance in patients with PD.

METHODS

As of March 1, 2024, a systematic search was conducted in PubMed, Web of Science, Embase, and the Cochrane Library to gather randomized controlled trials (RCTs) that report the effects of treadmill training on patients with PD. Data on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III), the Timed Up and Go test (TUG), the Berg Balance Scale (BBS),6-Minute Walk Test (6MWT),10 Meter Walk Test (10MWT), and the Parkinson's Disease Questionnaire-39 (PDQ-39) outcome metrics, as well as general characteristics of the studies, participant demographics, and details regarding the intervention and control groups, were extracted. The Cochrane Risk of Bias tool was employed to evaluate the quality of articles at risk, while the funnel plot and Egger's test were utilized to assess publication bias.

RESULTS

16 RCTs comprising 582 participants were included. The meta-analysis indicated that treadmill training (TT) produced significantly better outcomes than conventional therapy (CT) in the post-intervention assessments of motor symptoms (UPDRS-III: SMD: -0.45; 95% CI: -0.73 to -0.17), and gait performance (6MWT: SMD 0.53; 95% CI: 0.08 to 0.97; 10MWT: 0.93; 95% CI: 0.54 to 1.32). Body Weight Supporting Treadmill (BBS) for Better Healing However, quality of life (PDQ-39: SMD: -0.35; 95% CI: -0.95 to 0.25), balance (BBS: SMD SMD: -0.35; 95% CI: -0.95 to 0.25; TUG: SMD: -0.35; 95% CI: -0.95 to 0.25), and treatment effects were comparable.

CONCLUSION

TT (especially weight-supported) vs. conventional training demonstrates superior efficacy in enhancing lower limb mobility for Parkinson's disease, improving muscular endurance and short-term gait speed, but requires enhanced dynamic balance integration.

SYSTEMATIC TRIAL REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier, CRD42021256958.

摘要

背景

帕金森病（PD）是第二常见的神经退行性疾病，会导致下肢功能障碍，这是跌倒和残疾的关键因素，然而有效的康复方法仍然有限。

目的

系统评估跑步机训练对帕金森病患者下肢运动表现的影响。

方法

截至2024年3月1日，在PubMed、科学网、Embase和考克兰图书馆进行系统检索，以收集报告跑步机训练对帕金森病患者影响的随机对照试验（RCT）。提取统一帕金森病评定量表第三部分（UPDRS-III）、计时起立行走测试（TUG）、伯格平衡量表（BBS）、6分钟步行测试（6MWT）、10米步行测试（10MWT）和帕金森病问卷-39（PDQ-39）结果指标的数据，以及研究的一般特征、参与者人口统计学信息和干预组与对照组的详细信息。采用考克兰偏倚风险工具评估有风险文章的质量，同时利用漏斗图和埃格检验评估发表偏倚。

结果

纳入了16项RCT，共582名参与者。荟萃分析表明，在运动症状（UPDRS-III：标准化均值差（SMD）：-0.45；95%置信区间（CI）：-0.73至-0.17）和步态表现（6MWT：SMD 0.53；95%CI：0.08至0.97；10MWT：0.93；95%CI：0.54至1.32）的干预后评估中，跑步机训练（TT）比传统疗法（CT）产生的效果显著更好。然而，生活质量（PDQ-39：SMD：-0.35；95%CI：-0.95至0.25）、平衡（BBS：SMD SMD：-0.35；95%CI：-0.95至0.25；TUG：SMD：-0.35；95%CI：-0.95至0.25）和治疗效果相当。