The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease
The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease
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DOI：
10.1016/j.apmr.2008.01.013
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发表时间：
2008-07-01
影响因子：
4.3
通讯作者：
Petzinger, Giselle
中科院分区：
文献类型：
--
作者：
Fisher, Beth E.;Wu, Allan D.;Petzinger, Giselle
目的：获得关于高强度运动相对于低强度和无强度运动对帕金森病（PD）患者功能表现的影响的初步数据，并确定通过经颅磁刺激（TMS）测量的皮质运动兴奋性的改变是否伴随着性能改善。设计：队列（前瞻性），随机对照试验。设置：基于大学的临床和研究机构。参与者：30名PD患者，诊断为Hoehn和Yahr 1或2期。干预措施：受试者被随机分为高强度运动组（使用体重支持的跑步机训练）、低强度运动组或零强度教育组。2个运动组的受试者在8周内完成了24次运动。受试者在零强度组完成了6个教育类超过8 weeks.Main Outcome Measures：统一帕金森氏病评定量表（CAFRS），生物力学分析的自我选择和快速步行和坐站任务; corticomotor兴奋性进行了评估与皮质沉默期（CSP）持续时间在响应单脉冲TMS.Results：一个小的改善，在所有组中观察到的总和运动CAFRS。高强度组受试者在自选和快速步态中表现出运动后步态速度、步长和步幅以及髋关节和踝关节偏移的增加，并在坐立任务中改善了体重分布。在低强度和零强度组中，步态和坐立测量的改善并不一致。高强度组显示延长CSP.Conclusions：研究结果表明，运动的剂量依赖性的好处，高强度的运动可以正常皮质运动兴奋性在早期PD。
Objectives: To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).Design: Cohort (prospective), randomized controlled trial.Setting: University-based clinical and research facilities.Participants: Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2.Interventions: Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks.Main Outcome Measures: Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS.Results: A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP.Conclusions: The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD.