文章摘要
李学、马建军、李六一、杨红旗、祁亚伟、吴少璞、李东升、王文霞.平板训练联合音乐干预对帕金森病患者冻结步态的影响[J].中华物理医学与康复杂志,2016,38(5):344-348
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平板训练联合音乐干预对帕金森病患者冻结步态的影响
  
DOI:
中文关键词: 帕金森病  冻结步态  平板运动  音乐治疗
英文关键词: Parkinson′s disease  Gait freezing  Treadmill training  Music therapy
基金项目:河南省医学科技攻关计划项目(20110202129);河南省科技攻关计划项目(122102310154)
作者单位
李学、马建军、李六一、杨红旗、祁亚伟、吴少璞、李东升、王文霞 450003郑州河南省人民医院(郑州大学人民医院)神经内科 
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中文摘要:
      目的 观察平板训练联合音乐干预对帕金森病(PD)患者冻结步态的治疗作用。 方法 采用随机数字表法将56例PD伴冻结步态患者分为对照组、平板组、音乐组及联合治疗组。对照组患者给予常规抗PD药物(如左旋多巴、多巴胺受体激动剂等)治疗,根据每位患者实际情况酌情调整剂量及配伍。平板组、音乐组患者在上述药物治疗基础上分别辅以平板训练或音乐干预,联合治疗组则在常规药物治疗基础上辅以平板训练及音乐干预。于治疗前、治疗8周后分别采用冻结评分、起步时间、跌倒次数、统一帕金森病评分量表(UPDRS)-Ⅲ和改良Barthel指数(MBI)评分对各组患者疗效进行评定。 结果 治疗前4组患者冻结评分、起步时间、跌倒次数、UPDRS-Ⅲ及MBI评分组间差异均无统计学意义(P>0.05);治疗8周后平板组及联合治疗组上述疗效指标均较治疗前明显改善(P<0.05),而音乐组仅有UPDRS-Ⅲ及MBI评分较治疗前明显改善(P<0.05);通过进一步组间比较发现,治疗后联合治疗组冻结评分[(1.58±1.48)分]、起步时间[(3.58±3.23)s]、跌倒次数[(3.52±5.79)次]、UPDRS-Ⅲ评分[(22.51±7.54)分]及MBI评分[(49.71±28.38)分]均显著优于平板组、音乐组及对照组水平,组间差异均具有统计学意义(P<0.05)。 结论 平板训练联合音乐干预能显著缓解PD患者冻结步态,减少摔倒次数,对提高患者日常生活活动能力、改善生活质量具有重要意义,该联合疗法值得临床进一步推广、应用。
英文摘要:
      Objective To observe the effects of treadmill training and music therapy on freezing of gait among patients with Parkinson′s disease. Methods Fifty-six Parkinson′s disease patients with freezing of gait were randomly divided into a control group, a treadmill training group, a music group and a united group, each of fourteen. All groups received standard medication. The treadmill training group and the music group were also given treadmill training and music therapy respectively. The united group received both treadmill training and music therapy. All of the patients were assessed in terms of freezing score, time to start a first step, incidence of falls, UPDRS-Ⅲ scores and MBI scores before and after 8 weeks of intervention. Results There were no significant differences among the 4 groups before the training. Significant differences were observed in all of the measurements between the treadmill training and united groups after the treatment. In the music group, only the average UPDRS-Ⅲ and MBI results were significantly improved after the treatment. Compared with the treadmill training and music groups, the united group showed significant differences in all of the measurements. Conclusion Treadmill training combined with music therapy is more effective than either alone in relieving gait freezing among those with Parkinson′s disease. It decreases falling and improves their capacity in the activities of daily living life, thus their quality of life.
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