Hu Zekai, Shi Jing, Wang Jinyan, Liu Ting, Li Yujia, Xue Han, Jin Xueming, Xue Yiting, Wang Jie, Liu Xinhao, Hu Jun
Clinical Research Center, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.
Department of Rehabilitation Medicine, Baoshan Branch, Renji Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Psychiatry. 2025 Jul 18;16:1470847. doi: 10.3389/fpsyt.2025.1470847. eCollection 2025.
Sleep disorders are prevalent in Parkinson's disease (PD) patients, significantly impacting their quality of life and rehabilitation outcomes. This controlled trial aimed to investigate the impact of Yijinjing-inspired exercises on sleep disorders in PD patients, utilizing functional near-infrared spectroscopy (fNIRS) to assess neurophysiological changes.
Ninety-six PD patients were allocated to control, exercise, or music therapy groups for eight weeks. The Pittsburgh Sleep Quality Index (PSQI), along with the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), and Parkinson's Disease Questionnaire (PDQ-39) were used to assess outcomes. fNIRS measured neurophysiological changes post-intervention.
The exercise group demonstrated substantial improvement in sleep quality after Bonferroni correction (PSQI: mean Δ = -1.78 ± 0.99, < 0.001; Cohen's d = 1.45). Moderate effect sizes were observed in cognition (MoCA: d = 0.43) and motor function (UPDRS: d = 0.40), though these did not retain statistical significance after correction. Between-group analysis revealed greater PSQI reduction in exercise versus control (Δ = -1.19 ± 0.85 vs. -0.19 ± 1.53; = 0.001 after Bonferroni adjustment, Cohen's d = 0.87), but not versus music therapy ( = 0.018 > 0.0167). fNIRS confirmed cortical reorganization in dorsolateral prefrontal cortex (Brodmann Area 9; Channel 3) and primary motor cortex (Brodmann Area 4; Channel 9) at FDR-corrected < 0.05. The control group showed no statistically significant changes post-correction (all > 0.01).
Yijinjing training may improve sleep quality in Parkinson's disease patients, with preliminary evidence of neuroplastic adaptation. Consideration could be given to exploring its integration into comprehensive rehabilitation approaches.
睡眠障碍在帕金森病（PD）患者中普遍存在，严重影响他们的生活质量和康复效果。这项对照试验旨在研究易筋经启发式锻炼对PD患者睡眠障碍的影响，并利用功能近红外光谱（fNIRS）评估神经生理变化。
96名PD患者被分配到对照组、锻炼组或音乐治疗组，为期8周。使用匹兹堡睡眠质量指数（PSQI）以及蒙特利尔认知评估（MoCA）、简易精神状态检查表（MMSE）、统一帕金森病评定量表（UPDRS）和帕金森病问卷（PDQ-39）来评估结果。fNIRS测量干预后的神经生理变化。
在进行Bonferroni校正后，锻炼组的睡眠质量有显著改善（PSQI：平均变化量Δ=-1.78±0.99，P<0.001；Cohen's d=1.45）。在认知（MoCA：d=0.43）和运动功能（UPDRS：d=0.40）方面观察到中等效应量，尽管校正后这些未保持统计学显著性。组间分析显示，锻炼组与对照组相比，PSQI降低幅度更大（Δ=-1.19±0.85对-0.19±1.53；Bonferroni调整后P=0.001，Cohen's d=0.87），但与音乐治疗组相比则不然（P=0.018>0.0167）。fNIRS证实在经FDR校正后，背外侧前额叶皮层（布罗德曼区9；通道3）和初级运动皮层（布罗德曼区4；通道9）发生了皮质重组，P<0.05。对照组校正后无统计学显著变化（所有P>0.01）。
易筋经训练可能改善帕金森病患者的睡眠质量，并有神经可塑性适应的初步证据。可考虑探索将其纳入综合康复方法中。
