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

PDF (PC)

323

赞

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.
[1] 庞田英, 曾芳芳, 江小兰, 高茹, 谢林艳, 刘维, 鲁娟, 杨华. 喉切除术后吞咽功能评估与康复训练的循证护理实践[J]. 护理学报, 2023, 30(9): 49-54.
[2] 陈佳茵, 郭军, 刘宁. 护士职业暴露预防与管理的最佳证据总结[J]. 护理学报, 2023, 30(7): 53-58.
[3] 罗黎, 何娇, 张娟, 张岚, 杨雪娇. 新生儿尿布皮炎预防及管理的最佳证据总结[J]. 护理学报, 2023, 30(6): 42-46.
[4] 刘兰娟, 刘晓棠, 刘成, 张杰. 孕妇妊娠期运动的安全性有效性研究进展[J]. 护理学报, 2023, 30(6): 31-35.
[5] 李壮苗, 梦婷, 刘芳, 李霞, 李秀霞, 燕文娟. 艾盐包热熨手三阳经对脑卒中偏瘫患者上肢运动功能的影响[J]. 护理学报, 2023, 30(6): 61-67.
[6] 刘畅, 常婧, 焦雨晨, 许丽娟, 嵇艳. 轻度认知障碍患者运动干预的最佳证据总结[J]. 护理学报, 2023, 30(5): 53-58.
[7] 方艳艳, 李华俊, 冯子民, 黄丽华, 蒋梅梅. 便携式多功能下肢康复运动装置的研制与应用[J]. 护理学报, 2023, 30(4): 68-71.
[8] 柴燕燕, 李潇, 刘宁, 叶丽娟, 曹建琼. 造血干细胞移植患者口腔护理管理的最佳证据总结[J]. 护理学报, 2023, 30(3): 63-67.
[9] 李朴, 王梅, 宇丽, 刘敏, 李平, 张泓, 陈瑜, 胡雁, 胡少华. 神经重症患儿早期活动的最佳证据总结[J]. 护理学报, 2023, 30(2): 48-53.
[10] 吕俭霞, 叶丽, 李彬, 吴波, 张含凤, 江庆华, 殷利. 头颈肿瘤放化疗患者吞咽困难预防性训练指导方案的最佳证据总结[J]. 护理学报, 2023, 30(2): 54-59.
[11] 陈莹, 范远玉, 张亚南, 曹韶研, 蒋文中, 潘静. 尘肺病患者肺康复方案制定的最佳证据总结[J]. 护理学报, 2023, 30(10): 46-51.
[12] 吴秀强, 杨珍, 谢志勤, 杜韫雨, 杨丽娜, 陈诗涵. 护士道德困境干预的最佳证据总结[J]. 护理学报, 2023, 30(1): 47-52.
[13] 李牧玲, 甄莉, 朱木兰, 白雪洁, 温海飞, 周宏珍. 肠造口患者造口周围潮湿相关性皮肤损伤预防及护理的最佳证据总结[J]. 护理学报, 2023, 30(1): 41-46.
[14] 李翔, 冯英璞, 孟晓静, 周立民, 霍晓冉, 许梦敏, 王昊. 脑卒中患者口腔健康管理的最佳证据总结[J]. 护理学报, 2022, 29(9): 36-41.
[15] 陈芳芳, 叶灵晓, 胡雁, 郑亚华, 李娟, 楼钶楠, 刘梅, 胡康丽. 心脏起搏器术后患者早期运动康复的最佳证据总结[J]. 护理学报, 2022, 29(8): 53-58.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 何佳琪, 郝习君, 陈长香. 854名随迁老人社会融入困境及其影响因素分析[J]. 护理学报, 2023, 30(9): 1 -6 .
[2] 周梦娟, 朱晓丽, 张态, 段剑锋, 罗宇梅, 马维莉, 陆涵, 史婷婷, 杨怡霖, 李婷, 查耀蕾, 赵媛. 急性胰腺炎非重症患者住院时间延长预测模型的构建及验证[J]. 护理学报, 2023, 30(9): 7 -12 .
[3] 吕璐洋, 王华芬, 卢芳燕, 王燕, 蒋树英. 肝移植患儿家庭照顾者出院准备体验的质性研究[J]. 护理学报, 2023, 30(9): 13 -17 .
[4] 尚彬, 罗彩凤, 吕妃, 徐剑鸥, 吴静, 张许婷, 吴贤群. 护理人员资质过剩感潜在类别分析及其与离职意愿的关系[J]. 护理学报, 2023, 30(9): 18 -24 .
[5] 张楠, 马丽, 刘光英, 周学通, 安晓华, 滕敏. 缩短达芬奇机器人接台手术术前准备时间的PDCA实践[J]. 护理学报, 2023, 30(9): 25 -29 .
[6] 杨晓燕, 王静, 杨亚平. 教育游戏软件在护理教学中应用研究进展[J]. 护理学报, 2023, 30(9): 30 -32 .
[7] 吴娟, 柏晓玲, 杨曾桢, 李慧, 樊雅. 虚拟模拟训练脚本设计在护理教学中应用的研究进展[J]. 护理学报, 2023, 30(9): 33 -36 .
[8] 周祎敏, 姚宇哲, 叶旭春. 社区老年人对照护机器人感知与期望的Meta整合[J]. 护理学报, 2023, 30(9): 43 -48 .
[9] 庞田英, 曾芳芳, 江小兰, 高茹, 谢林艳, 刘维, 鲁娟, 杨华. 喉切除术后吞咽功能评估与康复训练的循证护理实践[J]. 护理学报, 2023, 30(9): 49 -54 .
[10] 罗仕妙, 林美珍, 王慧欣, 练柳兰, 刘杨晨, 胡喜燕, 龚小珍, 魏琳. 新入职护士自主学习能力在组织支持与职业韧性的中介作用[J]. 护理学报, 2023, 30(9): 55 -59 .