对于帕金森病患者来说,是否建议使用脑下深层刺激治疗物理治疗? 一个德尔菲共识研究研究
Matteo Guidetti1, Sara Marceglia2, Tommaso Bocci1,3
1Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142, Milan, MI, Italy.
Journal of neuroengineering and rehabilitation
|April 11, 2025
概括
物理疗法 (PT) 可以帮助最大限度地帮助患有帕金森病 (PwPD) 的患者获得脑下丘脑核深层刺激 (STN-DBS) 的好处. 专家建议使用常规PT来改善运动症状和生活质量.
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 神经外科 神经外科
背景情况:
- 脑下核深度大脑刺激 (STN-DBS) 对帕金森病 (PD) 提供了运动益处,但其对轴向症状和步态的影响尚不清楚.
- 物理治疗 (PT) 被认为可以改善PD的运动功能和多巴胺耐药症状.
- 需要进一步研究PT和STN-DBS的联合潜力.
研究的目的:
- 在患有帕金森病 (PwPD) 的人群中,建立专家共识,建议在下丘脑核深脑刺激 (STN-DBS) 后进行物理治疗 (PT).
- 定义PT与STN-DBS结合的角色和具体干预措施.
主要方法:
- 进行了系统范围审查,以收集PT后STN-DBS的现有数据.
- 召开了由21名DBS临床医生和运动康复专家组成的Delphi小组.
- 一个由39个问题组成的利克尔特尺度调查涉及STN-DBS后PT的一般和治疗特定方面.
主要成果:
- 虽然质量有限,但现有研究表明,PT可以改善接受STN-DBS的PwPD患者的平衡,步态和姿势.
- 专家小组强烈同意,PT可以改善运动症状和生活质量,补充STN-DBS.
- 由于STN-DBS的特异性,建议使用常规PT代替按摩或手动治疗.
结论:
- 物理疗法 (PT) 显示出最大限度地提高了帕金森病患者 (PwPD) 接受STN-DBS的临床结果的潜力,尽管缺乏高级别的证据.
- 进一步的研究,包括随机对照试验 (RCT),对于制定基于证据的PT后STN-DBS指南至关重要.
- 康复和DBS社区之间的合作是必要的,以推进该领域的研究.
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