上肢炼或训练对帕金森病患者手的敏捷性和功能的影响:系统性审查和元分析
Elizabeth L Proud1, Kimberly J Miller2, Meg E Morris3
1Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia.
Archives of physical medicine and rehabilitation
|December 2, 2023
概括
运动和训练有适度的证据表明,在帕金森病 (PD) 中改善了手的灵敏度. 然而,对自我报告的功能和手写的影响仍然不清楚,这表明未来干预的任务相关方法.
科学领域:
- 神经学 神经学
- 康复科学 康复科学 康复科学
- 运动障碍 运动障碍
背景情况:
- 帕金森病 (PD) 显著影响运动功能,包括手的灵巧和功能.
- 关于PD上肢功能的运动和训练干预措施有效性的证据有限.
研究的目的:
- 系统地审查运动和训练对帕金森病患者手的灵敏度和功能的影响.
- 评估这些干预措施的证据质量.
主要方法:
- 从开始到2022年10月,对随机对照试验 (RCT) 的系统审查,搜索了5个数据库.
- 包括重点关注上肢炼/培训的RCT,用于PD患者的上肢结果.
- 使用Cochrane偏差风险和GRADE工具评估的偏差风险和证据的强度.
主要成果:
- 包括18个RCT (n=704),偏差风险低至不明.
- 中等质量的证据表明,运动/训练对手内灵巧度 (SMD=0.26) 的积极影响很小.
- 非常低质量的证据表明对自我报告的手部功能没有显著影响,以及手写改进的低质量证据.
结论:
- 适度的证据确定性支持对帕金森病灵巧性问题的炼/训练.
- 关于自我报告的手部功能和手写的改善的证据仍然不清楚.
- 建议采用与任务相关的培训方法,未来需要对最佳剂量和干预组件进行研究.
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