Current Perspectives on Aerobic Exercise in People with Parkinson's Disease.
Current Perspectives on Aerobic Exercise in People with Parkinson's Disease.
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DOI：
10.1007/s13311-020-00904-8
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
de Vries NM
中科院分区：
文献类型：
--
作者：
Schootemeijer S;van der Kolk NM;Bloem BR;de Vries NM
帕金森病（PD）是一种进行性神经系统疾病，其特征在于运动和非运动症状，仅存在对症治疗。运动是一种被广泛研究的补充治疗方案。有氧运动的定义是，在一段持续的时间内，身体的大肌肉以有节奏的方式连续运动，增加热量需求，旨在保持或改善身体健康，似乎很有希望。我们对有氧运动对PD患者的一般和疾病特异性健康益处进行了范围审查和系统审查。我们通过对身体健康（VO 2 max），运动症状（运动障碍协会统一帕金森病评定量表（MDS-PDRS）运动部分）和健康相关生活质量（39项帕金森病问卷（PDQ-39））的影响进行荟萃分析来支持这一点。有氧运动对PD患者具有普遍的健康益处，包括降低心血管疾病的发病率，降低死亡率和改善骨骼健康。此外，有1级证据表明，有氧运动可改善身体健康（VO 2 max），并减轻停药状态下的运动症状（MDS-MRS运动部分），尽管长期影响（超过6个月）尚不清楚。运动的剂量很重要：与中等强度相比，高强度训练后的改善似乎更大。我们发现有氧运动对健康相关生活质量（PDQ-39）有益影响的证据不足，并且关于非运动症状的结果相互矛盾。PD患者对运动方案的依从性具有挑战性，但可以通过在训练计划中添加运动游戏元素来改善。有氧运动似乎是一个安全的干预与PD的人，虽然必须小心，以避免福尔斯在高危人群。需要进一步的研究来建立长期的有氧运动，包括关注非运动症状和健康相关的生活质量。本文的在线版本（10.1007/s13311-020-00904-8）包含补充材料，可供授权用户使用。
Parkinson’s disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body’s large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VO2max), motor symptoms (Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson’s disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VO2max) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life. The online version of this article (10.1007/s13311-020-00904-8) contains supplementary material, which is available to authorized users.
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