Intensive Rehabilitation Treatment in Early Parkinson's Disease: A Randomized Pilot Study With a 2-Year Follow-up
Intensive Rehabilitation Treatment in Early Parkinson's Disease: A Randomized Pilot Study With a 2-Year Follow-up
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DOI：
10.1177/1545968314542981
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发表时间：
2015-02-01
影响因子：
4.2
通讯作者：
Ghilardi, M. Felice
中科院分区：
文献类型：
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作者：
Frazzitta, Giuseppe;Maestri, Roberto;Ghilardi, M. Felice
背景虽然体育锻炼可以改善帕金森病（PD）的运动方面，但尚不清楚它是否也具有神经保护作用。Objective.在这项为期2年的随访研究中，我们确定了在疾病早期阶段的强化运动是否会减缓PD进展。方法. 40例新诊断的PD患者接受雷沙吉兰治疗，并随机分为2组：MIRT组（2次28天的多学科强化康复治疗[MIRT]，间隔1年）和对照组（仅药物）。在两组中，在基线（T0）、6个月（T1）、1年（T2）、18个月（T3）和2年（T4）时评估统一帕金森病评定量表第二部分（PDRS II）、PDRS III、6分钟步行试验（6 MWT）、定时起立行走试验（TUG）、PD残疾量表（PDDS）和左旋多巴等效物。结果在2年内，两组患者的TIRS II、TIRS III、TUG和PDDS的进展存在差异：在MIRT组中，T4时的所有评分均优于T0时（所有P均< .03）。在对照组中未观察到变化。左旋多巴等效剂量仅在对照组中显著增加（P = 0.0015），单药治疗患者的百分比降低（T1 40%; T2、T3和T4 20%）。在MIRT组中，此类患者的百分比仍然较高（T1和T2 100%; T3 89%; T4 75%）。结论.这些结果表明，MIRT可能会减缓运动衰退的进展，它可能会延迟增加药物治疗的需要，因此，它可能具有神经保护作用。
Background. Although physical exercise improves motor aspects of Parkinson's disease (PD), it is not clear whether it may also have a neuroprotective effect. Objective. In this 2-year follow-up study, we determined whether intensive exercise in the early stages of the disease slows down PD progression. Methods. Forty newly diagnosed patients with PD were treated with rasagiline and randomly assigned to 2 groups: MIRT Group (two 28-day multidisciplinary intensive rehabilitation treatments [MIRT], at 1-year interval) and Control Group (only drug). In both groups, Unified Parkinson's Disease Rating Scale Section II (UPDRS II), UPDRS III, 6-minute walking test (6MWT), Timed Up-and-Go test (TUG); PD Disability Scale (PDDS), and l-dopa equivalents were assessed at baseline (T0), 6 months (T1), 1 year (T2), 18 months (T3), and 2 years (T4) later. Results. Over 2 years, UPDRS II, UPDRS III, TUG, and PDDS differentially progressed in the 2 groups: In the MIRT Group, all scores at T4 were better than at T0 (all Ps < .03). No changes were noted in the Control Group. l-dopa equivalent dosages increased significantly only in the Control Group (P = .0015), with a decrease in the percentages of patients in monotherapy (T1 40%; T2, T3, and T4 20%). In the MIRT Group, the percentages of such patients remained higher (T1 and T2 100%; T3 89%; T4 75%). Conclusions. These results suggest that MIRT might slow down the progression of motor decay, it might delay the need for increasing drug treatment, and thus, it might have a neuroprotective effect.