{"title":"不同运动对改善帕金森病患者步态表现的影响：系统回顾和网络荟萃分析。","authors":"Ying Li, Jieling Huang, Jinguo Wang, Yue Cheng","doi":"10.3389/fnagi.2025.1496112","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Gait disorder represents a characteristic symptom of Parkinson's disease (PD), and exercise has been established as an effective intervention for gait management in PD. However, the relative efficacy of various exercise types in improving gait among PD patients remains unclear. This study aimed to compare the effectiveness of different movement-based interventions in enhancing gait for individuals with PD through a network meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The methodological quality of included studies was evaluated using the Cochrane Bias risk tool. Data was extracted from these studies to compare the efficacy of 29 distinct exercise interventions on gait performance in patients with PD.</p><p><strong>Results: </strong>The analysis encompassed 68 randomized controlled trials (RCTs), involving a total of 3,114 participants. The results of the network meta-analysis showed that DE is higher than CON (SMD, 2.11; 95% CI 1.07 to 3.15), WE (SMD, 2.16; 95% CI 0.90 to 3.43), HE (SMD, 2.19; 95% CI 0.95 to 3.44), OE (SMD, 2.66; 95% CI 1.16 to 4.16), TR (SMD, 2.62; 95% CI 1.45 to 3.79) to better improve Gait velocity in patients with Parkinson's disease. DE is superior to CON (SMD, 2.08; 95% CI 0.04 to 4.13) in improving Step length. FAE is superior to CON (SMD, 1.01; 95% CI 0.04 to 1.98), BDJ (SMD, 1.20; 95% CI 0.15 to 2.25), RAGT (SMD, 1.29; 95% CI 0.07 to 2.52), DE (SMD, 1.57; 95% CI 0.36 to 2.77), TR (SMD, 1.62; 95% CI 0.48 to 2.76), OE (1.76, 95% CI 0.57 to 2.94) in improving Gait velocity. RAGT is superior to CT (MD, 2.02; 95% CI 0.41 to 3.63), TR (MD, 2.51; 95% CI 1.17 to 3.84), AE (MD, 2.66; 95% CI 0.45 to 4.88), BDJ (MD, 2.77; 95% CI 0.93 to 4.61), CON (MD, 2.83; 95% CI 1.30 to 4.36), DTT (MD, 12.84; 95% CI 10.05 to 15.63) in improving 6MWT.</p><p><strong>Conclusion: </strong>Our study found that DE improved gait speed and step length in patients with Parkinson's disease better than other forms of exercise. FAE and RAGT were more effective than other exercises in improving step length and 6MWT in patients with Parkinson's disease.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1496112"},"PeriodicalIF":4.5000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897016/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of different exercises on improving gait performance in patients with Parkinson's disease: a systematic review and network meta-analysis.\",\"authors\":\"Ying Li, Jieling Huang, Jinguo Wang, Yue Cheng\",\"doi\":\"10.3389/fnagi.2025.1496112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Gait disorder represents a characteristic symptom of Parkinson's disease (PD), and exercise has been established as an effective intervention for gait management in PD. However, the relative efficacy of various exercise types in improving gait among PD patients remains unclear. This study aimed to compare the effectiveness of different movement-based interventions in enhancing gait for individuals with PD through a network meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The methodological quality of included studies was evaluated using the Cochrane Bias risk tool. Data was extracted from these studies to compare the efficacy of 29 distinct exercise interventions on gait performance in patients with PD.</p><p><strong>Results: </strong>The analysis encompassed 68 randomized controlled trials (RCTs), involving a total of 3,114 participants. The results of the network meta-analysis showed that DE is higher than CON (SMD, 2.11; 95% CI 1.07 to 3.15), WE (SMD, 2.16; 95% CI 0.90 to 3.43), HE (SMD, 2.19; 95% CI 0.95 to 3.44), OE (SMD, 2.66; 95% CI 1.16 to 4.16), TR (SMD, 2.62; 95% CI 1.45 to 3.79) to better improve Gait velocity in patients with Parkinson's disease. DE is superior to CON (SMD, 2.08; 95% CI 0.04 to 4.13) in improving Step length. FAE is superior to CON (SMD, 1.01; 95% CI 0.04 to 1.98), BDJ (SMD, 1.20; 95% CI 0.15 to 2.25), RAGT (SMD, 1.29; 95% CI 0.07 to 2.52), DE (SMD, 1.57; 95% CI 0.36 to 2.77), TR (SMD, 1.62; 95% CI 0.48 to 2.76), OE (1.76, 95% CI 0.57 to 2.94) in improving Gait velocity. RAGT is superior to CT (MD, 2.02; 95% CI 0.41 to 3.63), TR (MD, 2.51; 95% CI 1.17 to 3.84), AE (MD, 2.66; 95% CI 0.45 to 4.88), BDJ (MD, 2.77; 95% CI 0.93 to 4.61), CON (MD, 2.83; 95% CI 1.30 to 4.36), DTT (MD, 12.84; 95% CI 10.05 to 15.63) in improving 6MWT.</p><p><strong>Conclusion: </strong>Our study found that DE improved gait speed and step length in patients with Parkinson's disease better than other forms of exercise. FAE and RAGT were more effective than other exercises in improving step length and 6MWT in patients with Parkinson's disease.</p>\",\"PeriodicalId\":12450,\"journal\":{\"name\":\"Frontiers in Aging Neuroscience\",\"volume\":\"17 \",\"pages\":\"1496112\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897016/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Aging Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fnagi.2025.1496112\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Aging Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnagi.2025.1496112","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：步态障碍是帕金森病（PD）的特征性症状，运动已被确立为帕金森病步态管理的有效干预手段。然而，各种运动类型在改善PD患者步态方面的相对效果尚不清楚。本研究旨在通过网络荟萃分析，比较不同运动干预措施在改善PD患者步态方面的有效性。方法：在PubMed、Cochrane Library、Embase、Web of Science、CNKI等多个数据库中进行综合检索。采用Cochrane偏倚风险工具评估纳入研究的方法学质量。从这些研究中提取数据，比较29种不同的运动干预对PD患者步态表现的疗效。结果：该分析包括68项随机对照试验（rct），共涉及3,114名参与者。网络元分析结果显示，DE高于CON (SMD, 2.11；95% CI 1.07 - 3.15), WE (SMD, 2.16；95% CI 0.90 ~ 3.43), HE (SMD, 2.19；95% CI 0.95 ~ 3.44), OE (SMD, 2.66；95% CI 1.16 ~ 4.16), TR (SMD, 2.62；95% CI 1.45 - 3.79)更好地改善帕金森病患者的步态速度。DE优于CON (SMD, 2.08；95% CI 0.04 ~ 4.13)改善步长。FAE优于CON (SMD, 1.01；95% CI 0.04 ~ 1.98), BDJ (SMD, 1.20；95% CI 0.15 ~ 2.25), RAGT (SMD, 1.29；95% CI 0.07 ~ 2.52), DE (SMD, 1.57；95% CI 0.36 ~ 2.77), TR (SMD, 1.62；95% CI 0.48 ~ 2.76), OE （1.76, 95% CI 0.57 ~ 2.94）改善步态速度。RAGT优于CT (MD, 2.02；95% CI 0.41 ~ 3.63), TR (MD, 2.51；95% CI 1.17 ~ 3.84), AE (MD 2.66；95% CI 0.45 ~ 4.88), BDJ (MD, 2.77；95% CI 0.93 ~ 4.61), CON (MD, 2.83；95% CI 1.30 ~ 4.36), DTT (MD, 12.84；95% CI 10.05 ~ 15.63)改善6MWT。结论：我们的研究发现，与其他形式的运动相比，DE能更好地改善帕金森病患者的步态速度和步长。FAE和RAGT在改善帕金森病患者步长和6MWT方面比其他运动更有效。
Effects of different exercises on improving gait performance in patients with Parkinson's disease: a systematic review and network meta-analysis.
Objective: Gait disorder represents a characteristic symptom of Parkinson's disease (PD), and exercise has been established as an effective intervention for gait management in PD. However, the relative efficacy of various exercise types in improving gait among PD patients remains unclear. This study aimed to compare the effectiveness of different movement-based interventions in enhancing gait for individuals with PD through a network meta-analysis.
Methods: A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The methodological quality of included studies was evaluated using the Cochrane Bias risk tool. Data was extracted from these studies to compare the efficacy of 29 distinct exercise interventions on gait performance in patients with PD.
Results: The analysis encompassed 68 randomized controlled trials (RCTs), involving a total of 3,114 participants. The results of the network meta-analysis showed that DE is higher than CON (SMD, 2.11; 95% CI 1.07 to 3.15), WE (SMD, 2.16; 95% CI 0.90 to 3.43), HE (SMD, 2.19; 95% CI 0.95 to 3.44), OE (SMD, 2.66; 95% CI 1.16 to 4.16), TR (SMD, 2.62; 95% CI 1.45 to 3.79) to better improve Gait velocity in patients with Parkinson's disease. DE is superior to CON (SMD, 2.08; 95% CI 0.04 to 4.13) in improving Step length. FAE is superior to CON (SMD, 1.01; 95% CI 0.04 to 1.98), BDJ (SMD, 1.20; 95% CI 0.15 to 2.25), RAGT (SMD, 1.29; 95% CI 0.07 to 2.52), DE (SMD, 1.57; 95% CI 0.36 to 2.77), TR (SMD, 1.62; 95% CI 0.48 to 2.76), OE (1.76, 95% CI 0.57 to 2.94) in improving Gait velocity. RAGT is superior to CT (MD, 2.02; 95% CI 0.41 to 3.63), TR (MD, 2.51; 95% CI 1.17 to 3.84), AE (MD, 2.66; 95% CI 0.45 to 4.88), BDJ (MD, 2.77; 95% CI 0.93 to 4.61), CON (MD, 2.83; 95% CI 1.30 to 4.36), DTT (MD, 12.84; 95% CI 10.05 to 15.63) in improving 6MWT.
Conclusion: Our study found that DE improved gait speed and step length in patients with Parkinson's disease better than other forms of exercise. FAE and RAGT were more effective than other exercises in improving step length and 6MWT in patients with Parkinson's disease.
期刊介绍：
Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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