Ginanneschi Federica, Cioncoloni David, Battisti Carla, Bucciarelli Armando, Dominici Federica, Marconi Roberto, Rossi Alessandro, Monti Lucia
Department of Medical, Surgical and Neurological Sciences, AOUS, Siena, Italy.
Unit of Neurology, Cardio-Thoracic-Neuro-Vascular Department, Misericordia Hospital, Grosseto, Italy.
Front Neurol. 2025 Jul 8;16:1618719. doi: 10.3389/fneur.2025.1618719. eCollection 2025.
Gait dysfunction has emerged as the greatest challenge in Parkinson disease (PD) management. Decreased vestibular efficacy may contribute to imbalance in PD. The present study aims to explore whether an upper limb aerobic exercise, performed using a device that primarily targets the axial muscles of the cervical-dorsal spine, can improve postural control and motor symptoms in PD.
Twenty-eight patients with PD were evaluated before and after 2 months of exercise training, using dynamic posturography for the 6 conditions of the Sensory Integration Test (SOT) within the Equitest device, along with clinical measures. The effects of two exercise modes-supervised exercise (SE) and not supervised, voluntary exercise (VE)-were analyzed. Unified Parkinson Disease. Rating Scale (UPDRS) Part III and Hoehn and Yahr scale were used for clinical evaluation.
A significant improvement in vestibular SOT values was observed only in subjects belonging to the SE group (55.6 ± 14.9 pre-training vs. 65 ± 11.2 post training, = 0.017). Somatosensory and visual SOT scores did not change after training in any group. Both clinical scales showed statistically significant improvement after 8 weeks of training, but only in the SE group ( = 0.031) for the Hoehn and Yahr scale, and = 0.007 for UPDRS Part III, indicating clinical improvement in the SE group.
Active assistive SE performed with upper limbs can improve the utilization of vestibular information, and, consequently, enhance motor performance in PD patients. It should therefore be considered a crucial treatment methodology for PD patients especially those with motor limitations in the lower limbs.
步态功能障碍已成为帕金森病（PD）管理中最大的挑战。前庭功能下降可能导致PD患者失衡。本研究旨在探讨使用主要针对颈背脊柱轴向肌肉的设备进行的上肢有氧运动是否能改善PD患者的姿势控制和运动症状。
28例PD患者在进行2个月运动训练前后接受评估，使用Equitest设备中感觉整合测试（SOT）的6种条件下的动态姿势描记法以及临床测量方法。分析了两种运动模式——监督运动（SE）和非监督自主运动（VE）的效果。使用统一帕金森病评定量表（UPDRS）第三部分和Hoehn-Yahr量表进行临床评估。
仅在SE组患者中观察到前庭SOT值有显著改善（训练前55.6±14.9，训练后65±11.2，P = 0.017）。在任何组中，训练后体感和视觉SOT评分均未改变。两个临床量表在训练8周后均显示出统计学上的显著改善，但仅在SE组中，Hoehn-Yahr量表的P值为0.031，UPDRS第三部分的P值为0.007，表明SE组有临床改善。
上肢进行的主动辅助SE可以提高前庭信息的利用率，从而增强PD患者的运动表现。因此，对于PD患者，尤其是那些下肢存在运动限制的患者，应将其视为一种关键的治疗方法。
