Responsiveness of Objective vs. Clinical Balance Domain Outcomes for Exercise Intervention in Parkinson's Disease.
Responsiveness of Objective vs. Clinical Balance Domain Outcomes for Exercise Intervention in Parkinson's Disease.
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目标与临床平衡领域结果的反应性，用于帕金森氏病的运动干预。
DOI：
10.3389/fneur.2020.00940
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发表时间：
2020
影响因子：
3.4
通讯作者：
Mancini M
中科院分区：
文献类型：
--
作者：
Hasegawa N;Shah VV;Harker G;Carlson-Kuhta P;Nutt JG;Lapidus JA;Jung SH;Barlow N;King LA;Horak FB;Mancini M
背景：药物或手术治疗通常无法改善帕金森病 (PD) 患者的平衡缺陷。尽管平衡运动干预已被证明可以改善平衡的临床测量，但运动对不同客观平衡领域的功效仍然未知。目的：比较认知挑战敏捷训练营 (ABC-C) 干预后几个不同平衡和步态领域的客观和临床测量变化的敏感性。方法：在这项交叉、随机设计中，86 名 PD 患者参加了为期 6 周（3 次/周）的 ABC-C 运动课程和 6 周的教育课程，由 3-6 人组成。盲人检查员在实际关闭状态下对人们进行测试。可穿戴传感器的客观结果测量量化了平衡的四个领域：站立平衡的摇摆、步伐开始期间的预期姿势调整 (APA)、对推和释放测试的姿势反应，以及有或没有认知任务的 2 分钟自然速度步行。临床结果测量包括统一帕金森病评定量表 (MDS-UPDRS) 第三部分、迷你平衡评估系统测试 (Mini-BESTest)、平衡信心活动 (ABC) 和帕金森病问卷 (PDQ-39)。每次干预前后差异的标准化反应均值（SRM）比较了干预结果的反应性。线性混合模型比较了运动与主动控制教育干预的效果。结果：对 SRM > 0.5 的运动干预反应最灵敏的结果测量是步态和 APA 的客观测量，特别是手臂运动范围、双任务步行期间的步态速度、躯干冠状运动范围、足部着地角度和迈步开始时的第一步长度。最有效的临床结果指标是患者报告的 PDQ-39 活动日常生活分项评分，但所有临床指标的 SRM <0.5。结论：与临床测量相比，客观测量对运动干预后的变化更敏感。步态的时空参数，包括双重任务的步态速度和 APA 是最敏感的客观指标，感知功能独立性是 ABC-C 运动干预后改变的最敏感的临床指标。未来改善 PD 步态和平衡的运动干预应包括客观结果测量。
Background: Balance deficits in people with Parkinson's disease (PD) are often not helped by pharmacological or surgical treatment. Although balance exercise intervention has been shown to improve clinical measures of balance, the efficacy of exercise on different, objective balance domains is still unknown. Objective: To compare the sensitivity to change in objective and clinical measures of several different domains of balance and gait following an Agility Boot Camp with Cognitive Challenges (ABC-C) intervention. Methods: In this cross-over, randomized design, 86 individuals with PD participated in 6-week (3×/week) ABC-C exercise classes and 6-week education classes, consisting of 3–6 individuals. Blinded examiners tested people in their practical off state. Objective outcome measures from wearable sensors quantified four domains of balance: sway in standing balance, anticipatory postural adjustments (APAs) during step initiation, postural responses to the push-and-release test, and a 2-min natural speed walk with and without a cognitive task. Clinical outcome measures included the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, the Mini Balance Evaluation Systems Test (Mini-BESTest), the Activities of Balance Confidence (ABC), and the Parkinson's Disease Questionnaire (PDQ-39). The standardized response means (SRM) of the differences between before and after each intervention compared responsiveness of outcomes to intervention. A linear mixed model compared effects of exercise with the active control—education intervention. Results: The most responsive outcome measures to exercise intervention with an SRM > 0.5 were objective measures of gait and APAs, specifically arm range of motion, gait speed during a dual-task walk, trunk coronal range of motion, foot strike angle, and first-step length at step initiation. The most responsive clinical outcome measure was the patient-reported PDQ-39 activities daily living subscore, but all clinical measures had SRMs <0.5. Conclusions: The objective measures were more sensitive to change after exercise intervention compared to the clinical measures. Spatiotemporal parameters of gait, including gait speed with a dual task, and APAs were the most sensitive objective measures, and perceived functional independence was the most sensitive clinical measure to change after the ABC-C exercise intervention. Future exercise intervention to improve gait and balance in PD should include objective outcome measures.
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DOI：
10.1155/2013/572134
发表时间：
2013
期刊：
Parkinson's disease
影响因子：
--
作者：
King LA;Salarian A;Mancini M;Priest KC;Nutt J;Serdar A;Wilhelm J;Schlimgen J;Smith M;Horak FB
通讯作者：
Horak FB
影响因子：
3.5
作者：
Franchignoni F;Horak F;Godi M;Nardone A;Giordano A
通讯作者：
Giordano A
影响因子：
4.3
作者：
El-Gohary M;Peterson D;Gera G;Horak FB;Huisinga JM
通讯作者：
Huisinga JM
影响因子：
5.2
作者：
Capato, Tamine T. C.;de Vries, Nienke M.;Bloem, Bastiaan R.
通讯作者：
Bloem, Bastiaan R.
影响因子：
11
作者：
HUGHES, AJ;DANIEL, SE;LEES, AJ
通讯作者：
LEES, AJ