减重平板训练对老年帕金森病患者姿势和平衡能力的改善作用

doi:10.3877/cma.j.issn.2095-8757.2019.04.007

目的

探讨减重平板训练对老年帕金森病（parkinson's disease, PD）患者姿势和平衡能力的改善作用。

方法

选取2018年1月至2019年6月浙江医院收治的74例老年PD患者，其中采用常规药物联合传统物理训练进行康复治疗38例（对照组），在对照组治疗基础上给予减重平板训练进行康复治疗36例（观察组）。采用统一帕金森病评分量表（unified rating scale for Parkinson's disease, UPDRS）Ⅲ评估步态和姿势异常；采用Berg平衡量表（Berg balance scale, BBS）评估平衡能力；采用功能独立性评定量表（functional independence measure, FIM）评估运动能力。比较分析两组患者治疗前后UPDRSⅢ、BBS、FIM评分的差异。组间及组内比较均采用t检验。

结果

与治疗前比较，观察组和对照组治疗后UPDRSⅢ评分、BBS评分、FIM评分均明显增高（t=2.815、3.016、4.281，2.035、2.049、2.234；均P<0.05）。两组患者治疗前UPDRSⅢ评分、BBS评分、FIM评分的差异均无统计学意义（t=0.975、0.784、0.539，P>0.05）；观察组治疗后UPDRSⅢ评分、BBS评分、FIM评分均明显高于对照组（t=2.346、2.035、3.014，P<0.05）。

结论

减重平板训练能有效改善老年帕金森病患者的姿势和平衡能力。

关键词: 减重平板训练, 帕金森病, 姿势, 平衡

Objective

To explore the effect of body weight supported treadmill training (BWSTT) on posture and balance of patients with Parkinson's disease.

Methods

74 patients with Parkinson's disease admitted in Zhejiang Hospital from January 2018 to June 2019 were selected. They were divided into 2 groups. The control group (38 cases) was treated with conventional drugs combined with conventional physical therapy (CPT). The observation group (36 cases) was involved with BWSTT on the basis of the treatment of control group. Unified rating scale for Parkinson's disease (UPDRS)Ⅲwas used to assess abnormal gait and posture, berg balance scale (BBS) was used to assess balanced capacity, functional independence measure (FIM) was used to assess athletic ability. Scores of UPDRSⅢ, BBS and FIM were compared before and after treatment.Ttest was used for comparison between groups and within groups.

Results

The scores of UPDRSⅢ, BBS, and FIM of the two groups after treatment were both significantly higher compared with those before treatment (t=2.815, 3.016, 4.281, 2.035, 2.049, 2.234, allP < 0.05). There were no significant differences in scores of UPDRSⅢ, BBS, and FIM between control group and observation group before treatment (t=0.975, 0.784, 0.539, allP> 0.05). After treatment, the scores of UPDRSⅢ, BBS, and FIM of observation group were significantly highe than those in the control group (t=2.346, 2.035, 3.014, allP < 0.05).

Conclusion

BWSTT can effectively improve the posture and balance capacity of patients with Parkinson's disease.

Key words: Body-weight supported treadmill training, Parkinson's disease, Posture, Balance

表1 两组患者一般资料表的比较

组别	例数	性别（男/女，例）	年龄（岁）	病程（年）	MMSE评分
对照组	38	12/7	68.2±5.3	4.34±0.66	25.26±2.84
观察组	36	10/7	67.5±5.5	5.09±0.57	26.54±3.45
检验值	?	χ²=0.076	t=0.657	t=0.815	t=0.438
P值	?	>0.05	>0.05	>0.05	>0.05

表1 两组患者一般资料表的比较

组别	例数	性别（男/女，例）	年龄（岁）	病程（年）	MMSE评分
对照组	38	12/7	68.2±5.3	4.34±0.66	25.26±2.84
观察组	36	10/7	67.5±5.5	5.09±0.57	26.54±3.45
检验值	?	χ²=0.076	t=0.657	t=0.815	t=0.438
P值	?	>0.05	>0.05	>0.05	>0.05

表2 两组患者治疗前后各项评分的比较（分）

组别	例数	UPDRSⅢ评分		BBS评分		FIM评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	38	8.76±1.55	12.63±1.78	37.57±4.14	43.08±3.58	62.35±5.24	80.86±5.13
对照组	36	8.64±1.27	10.75±1.52	36.56±3.12	41.04±4.25	64.38±4.65	76.40±5.40
t值	?	0.975	2.346	0.784	2.035	0.539	3.014
P值	?	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05

表2 两组患者治疗前后各项评分的比较（分）

组别	例数	UPDRSⅢ评分		BBS评分		FIM评分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	38	8.76±1.55	12.63±1.78	37.57±4.14	43.08±3.58	62.35±5.24	80.86±5.13
对照组	36	8.64±1.27	10.75±1.52	36.56±3.12	41.04±4.25	64.38±4.65	76.40±5.40
t值	?	0.975	2.346	0.784	2.035	0.539	3.014
P值	?	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05

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Effect of improvement of body-weight supported treadmill training on posture and balance of elderly patients with Parkinson's disease

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Effect of improvement of body-weight supported treadmill training on posture and balance of elderly patients with Parkinson's disease