以质量求发展，以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (9): 37-42.doi: 10.16460/j.issn1008-9969.2023.09.037

• 循证护理 • 上一篇    下一篇

早中期帕金森病患者运动管理的最佳证据总结

杨琰1a, 董泗芹1a, 赵宝生2, 李振香1b   

  1. 1.山东第一医科大学附属省立医院 a.老年神经内科;b.门诊部,山东 济南 250021;
    2.山东大学 护理与康复学院,山东 济南 250012
  • 收稿日期:2022-11-12 出版日期:2023-05-10 发布日期:2023-06-08
  • 通讯作者: 李振香（1964-）,女,山东烟台人,硕士,主任护师,门诊部主任。E-mail：zhenxiangsd@163.com
  • 作者简介:杨琰（1985-）,女,山东济南人,硕士,主管护师。
  • 基金资助:
    山东省重点研发计划项目（2016GSF201224）

Best evidence summary for exercise management for patients in early and middle stage of Parkinson's disease

YANG Yan1a, DONG Si-qin1a, ZHAO Bao-sheng2, LI Zhen-xiang1b   

  1. 1a. Dept. of Geriatric Neurology; b. Dept. of Outpatient, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China;
    2. School of Nursing and Rehabilitation, Shandong University, Jinan 250012, China
  • Received:2022-11-12 Online:2023-05-10 Published:2023-06-08

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摘要： 目的 检索汇总早中期帕金森病患者运动管理的相关证据,并总结最佳证据,为指导早中期帕金森病患者运动锻炼提供依据。方法 确定循证问题,计算机检索UpToDate、JBI、BMJ 、NGC、NICE 、RNAO、GIN、Cochrane Library、PubMed、Web of Science、Embase、PEDro、中国知网、万方数据库、维普数据库、中国生物医学文献服务网及美国帕金森病协会、美国物理治疗协会网站,由2名研究员对文献质量进行评价,并对符合质量标准的文献进行证据提取。结果 共纳入18篇文献,其中指南4篇、专家意见2篇、系统评价11篇、质性系统评价1篇。分析总结后提取了包括运动时机、运动评估与测试、运动实施、运动安全、健康教育、效果评价6个方面的29条项目。结论 本研究总结早中期帕金森病患者运动管理的相关证据,运动可改善帕金森的症状,医护人员需依据评估结果,参考患者的实际情况,进行个性化运动指导,以期延缓疾病进展,提高生活质量。

关键词: 帕金森, 运动, 证据总结, 循证护理

Abstract: Objective To retrieve and summarize the best evidence for exercise management for patients in the early and middle stage of Parkinson's disease and to provide exercise guidance for patients with Parkinson's disease. Methods Evidence-based problems were identified and we searched UpToDate, JBI, BMJ, NGC, NICE, RNAO, GIN, Cochrane Library, PubMed, Web of Science, Embase, PEDro, CNKI, Wanfang Data, VIP, CBM, APDA and APTA for eligible literature. Two researchers independently appraised articles and extracted data. Results A total of 18 articles were eligible, including 4 guidelines, 2 expert consensuses, 11 systematic reviews and 1 systematic review, and 29 pieces of evidence were summarized into 6 aspects: exercise timing, assessment and testing, exercise implementation, safety, health education and effect evaluation. Conclusion Exercise can alleviate symptoms of Parkinson's disease. Personalized exercise programs for patients in accordance with the assessment and the situation of patients are conducive to slowing down the disease progression and improving the quality of life.

Key words: Parkinson's disease, exercise, evidence summary, evidence-based nursing

中图分类号: 

  • R473.74
[1] Li G, Ma J, Cui S, et al.Parkinson's disease in China: a forty-year growing track of bedside work[J]. Transl Neurodegener, 2019,8(1):22.DOI:10.1186/s40035-019-0162-z.
[2] 张世西,何月月,尹安春,等.帕金森病患者照顾者照护体验质性研究的Meta整合[J].护理学报,2020,27(22):45-51.DOI:10.16460/j.issn1008-9969.2020.22.045.
[3] Mak MK, Wong-Yu IS, Shen X, et al.Long-term effects of exercise and physical therapy in people with Parkinson disease[J].Nat Rev Neurol, 2017,13(11):689-703.DOI:10.1038/nrneurol.2017.128.
[4] Reynolds GO, Otto MW, Ellis TD, et al.The therapeutic potential of exercise to improve mood, cognition, and sleep in Parkinson's disease[J]. Mov Disord, 2016,31(1):23-38.DOI:10.1002/mds.26484.
[5] 赵青, 龚英, 王志琼, 等. 帕金森健康操对帕金森病患者运动功能的干预研究[J]. 护理学报, 2020,27(4):52-56.DOI:10.16460/j.issn1008-9969.2020.04.052.
[6] Canning CG, Sherrington C, Lord SR, et al.Exercise for falls prevention in Parkinson disease: a randomized controlled trial[J]. Neurology, 2015,84(3):304-312.DOI:10.1212/WNL.0000000000001155.
[7] 杨晓梅, 徐岩, 孙圣刚, 等. 帕金森病实施个体化运动处方的建议[J]. 临床内科杂志, 2021,38(3):208-210.DOI:10.3969/j.issn.1001-9057.2021.03.021.
[8] 王翔宇, 董青, 董双双, 等. 八段锦联合平衡训练改善帕金森病运动和非运动症状的效果[J]. 中国康复理论与实践, 2021,27(1):111-116.DOI:10.3969/j.issn.1006-9771.2021.01.017.
[9] 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017,32(21):1991-1994.DOI:10.16821/j.cnki.hsjx.2017.21.025.
[10] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010,182(18):E839-E842.DOI:10.1503/cmaj.090449.
[11] 郝玉芳,胡雁. 循证护理学[M]. 北京:人民卫生出版社, 2018.
[12] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志, 2015,30(11):964-967.
[13] Martignon C, Pedrinolla A, Ruzzante F, et al.Guidelines on exercise testing and prescription for patients at different stages of Parkinson's disease[J].Aging Clin Exp Res, 2021,33(2):221-246.DOI:10.1007/s40520-020-01612-1.
[14] Ellis T, DeAngelis TR, Dalton D, et al. A guide to exercise and wellness for people with Parkinson's disease[S]. Boston: American Parkinson Disease Association, 2018.
[15] Keus SHJ, Munneke M, Graziano M, et al.European Physiotherapy Guideline for Parkinson's Disease[S]. Netherlands:KNGF/ParkinsonNet, 2014.
[16] National Institute for Health and Care Excellence.National institute for health and care excellence: clinical guidelines.Parkinson's disease in adults[S]. London: National Institute for Health and Care Excellence, 2017.
[17] Gallo PM, Mendola NM.Exercise prescription recommendations for Parkinson's disease[J]. Strength and Conditioning Journal, 2018, 5(40):126-133.DOI:10.1519/SSC.0000000000000415.
[18] 中华医学会神经病学分会神经康复学组,中国微循环学会神经变性病专业委员会康复学组,中国康复医学会帕金森病与运动障碍康复专业委员会.帕金森病康复中国专家共识[J].中国康复理论与实践,2018,24(7):745-752.DOI:10.3969/j.issn.1006-9771.2018.00.002.
[19] Ban M, Yue X, Dou P, et al.The effects of yoga on patients with Parkinson's disease: a Meta-analysis of randomized controlled trials[J]. Behavioural Neurology,2021(1):1-11.DOI:10.1155/2021/5582488.
[20] Cristini J, Weiss M, De Las Heras B, et al. The effects of exercise on sleep quality in persons with Parkinson's disease:a systematic review with Meta-analysis[J]. Sleep Medicine Reviews,2021, 55(1):101384.DOI:10.1016/j.smrv.2020.101384.
[21] Cugusi L, Manca A, Bergamin M, et al.Aquatic exercise improves motor impairments in people with Parkinson's disease, with similar or greater benefits than land-based exercise: a systematic review[J]. J Physiother, 2019,65(2):65-74.DOI:10.1016/j.jphys.2019.02.003.
[22] De Oliveira MPB, Lobato DFM, Smaili SM, et al.Effect of aerobic exercise on functional capacity and quality of life in individuals with Parkinson's disease: a systematic review of randomized controlled trials[J]. Archives of Gerontology and Geriatrics, 2021, 95(1):104422. DOI:10.1016/j.archger.2021.104422.
[23] Elena P, Demetris S, Christina M, et al.Differences between exergaming rehabilitation and conventional physiotherapy on quality of life in Parkinson's disease: a systematic review and Meta-analysis[J]. Frontiers in Neurology, 2021,12(1):683385.DOI:10.3389/fneur.2021.683385.
[24] Forte R, Tocci N, De Vito G.The impact of exercise intervention with rhythmic auditory stimulation to improve gait and mobility in Parkinson disease: an umbrella review[J]. Brain sciences, 2021,11(6):685.DOI:10.3390/brainsci11060685.
[25] Hasan SM, Alshafie S, Hasabo EA, et al.Efficacy of dance for Parkinson's disease: apooled analysis of 372 patients[J]. J Neurol,2021,3(269):1195-1208.DOI:10.1007/s00415-021-10589-4.
[26] Mehrholz J, Kugler J, Storch A, et al.Treadmill training for patients with Parkinson's disease[J]. Cochrane Database Syst Rev, 2015, 2015(8):D7830. DOI:10.1002/14651858.CD007830.pub3.
[27] Saltychev M, Bärlund E, Paltamaa J, et al.Progressive resistance training in Parkinson's disease: a systematic review and Meta-analysis[J]. BMJ Open, 2016,6(1):e8756.DOI:10.1136/bmjopen-2015-008756.
[28] Shen X, Wong-Yu ISK, Mak MKY.Effects of Exercise on falls, balance, and gait ability in Parkinson's disease[J]. Neurorehabilitation and Neural Repair, 2016, 30(6):512-527.DOI:10.1177/1545968315613447.
[29] Tomlinson CL, Herd CP, Clarke CE, et al.Physiotherapy for Parkinson's disease: a comparison of techniques[J]. Cochrane Database Syst Rev, 2014,2014(6):D2815.DOI:10.1002/14651858.CD002815.pub2.
[30] Hunter H, Lovegrove C, Haas B, et al.Experiences of people with Parkinson's disease and their views on physical activity interventions[J]. JBI Database of Systematic Reviews and Implementation Reports, 2019, 17(4):548-613.DOI:10.11124/JBISRIR-2017-003901.
[31] Mak MK, Wong-Yu IS, Shen X, et al.Long-term effects of exercise and physical therapy in people with parkinson disease[J]. Nat Rev Neurol, 2017,13(11):689-703.DOI:10.1038/nr-neurol.2017.128.
[32] McDonnell, Michelle N. Lee silverman voice treatment (LSVT)-BIG to improve motor function in people with Parkinson's disease: a systematic review and Meta-analysis[J]. Clin Rehabil, 2018, 32(5):607-618. DOI:10.1177/0269215517734385
[33] Dockx K, Bekkers EM, Van den Bergh V, et al. Virtual reality for rehabilitation in Parkinson's disease[J]. Cochrane Database Syst Rev,2016, 12(12):D10760.DOI:10.1002/14651858.C-D010760.pub2.
[34] 彭雨燕. 帕金森患者功能锻炼依从性问卷编制及现状调查[D].南昌:南昌大学,2017.
[35] Picha KJ, Jochimsen KN, Heebner NR, et al.Measurements of self-efficacy in musculos-keletal rehabilitation: a systematic rreview[J]. Musculoskeletal Care, 2018,16(4):471-488.DOI:10.1002/msc.1362.
[36] 裴丽,王燕,张清.中老年运动现状及与焦虑抑郁、运动自我效能的关系[J].中国老年学杂志,2018,38(1):215-217.DOI:10.3969/j.issn.1005-9202.2018.01.091.
[37] 刘雪冰,王艳静. 自我效能护理在提升慢性心力衰竭患者依从性及生活质量中的应用效果[J].慢性病学杂志,2021,22(6):908-909;912. DOI:10.16440/j.cnki.1674-8166.2021.06.027.
[38] 安秀丽,张莉,梁丽娜.个性化健康教育联合同伴支持对老年糖尿病患者自我管理的影响[J].中国老年学杂志,2017,37(12):3054-3056.DOI:10.3969/j.issn.1005-9202.2017.12.089.
[39] Wu PL, Lee M, Huang TT.Effectiveness of physical activity on patients with depression and Parkinson's disease: a systematic review[J]. PLoS One,2017,12(7):e0181515. DOI:10.1371/journal.pone.0181515.
[40] 胡运新,孙永奇,李璇,等.帕金森病睡眠障碍与认知障碍关联性研[J].中国神经精神疾病杂志, 2022, 48(1):14-20.DOI:10.3969/j.issn.1002-0152.2022.01.003.
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