视听觉综合提示训练对改善帕金森病患者运动功能的作用

Visual and auditory cues improve motor function of patients with Parkinson's disease

目的:探讨视听觉综合提示训练对帕金森病患者平衡和步行等运动功能的影响。方法:选择原发性帕金森病患者25例(Hoehn-Yahr分期1.5—3期),其中男性15例,女性10例,平均年龄(62.23±10.79)岁。接受1周的住院强化视听觉综合提示训练后,为患者制定家庭训练处方,指导患者应用该方法家庭训练3个月。训练前、训练1周后、训练3个月后分别进行站立位足底压力测定、Berg平衡量表、起立—行走测试、6min步行试验、统一的帕金森病评定量表评估以及三维步态分析,比较训练前后平衡及步态时空参数的变化。结果:训练1周后及训练3个月后与训练前比较,患者平衡功能、起立—行走测试、6min步行距离、UPDRSⅡ和Ⅲ及跨步长、步速等指标均有显著改善(P<0.05)。训练1周后及训练3个月后与训练前比较,平衡能力分别提高9.21%和14.91%,跨步长分别提高13.41%和26.83%,步行速度分别提高14.86%和28.38%。此外,患者6min步行距离分别提高10.08%和25.89%,起立—行走计时时间分别减少6.63%和14.90%。训练1周后与训练3个月后比较,各指标差异无显著性意义(P>0.05)。结论:药物治疗基础上运用视听觉综合提示可显著改善帕金森病患者平衡功能及步行能力,有助于提高患者运动功能。

Objective： To investigate the effect of visual and auditory cues on the improvement of motor function for pa- tients with Parkinson＇s disease （PD）（e.g. balance and gait）. Method： Patients with idiopathic PD （15 men and 10 women; average age was 62.23±10.79 years） were en- rolled in the study. After one-week reinforced visual and auditory cues training, the visual and auditory cues were used by patients as family therapy for three months. The plantar pressure measurement at standing posi- tion, Berg Balance Scale, Timed Up and Go test （TUGT）, Six-Minute Walk Test （6MWT）, Unified Parkinson＇s Disease Rating Scale （UPDRS）, and three-dimensional gait performance analysis were carried out before train- ing, one week and three months after training, respectively, to evaluate the improvement on balance and gait performance from aspects of temporal and spatial alteration. Result： After one week and three months training, the balance and gait performance improved significantly compared with before training （P〈 0.05）. After one week and three months training, patients＇ balance ability was improved by 9.21% and 14.91%, stride length was improved by 13.31% and 26.83%, gait velocity was ira-proved by 14.86% and 28.38%, 6MWT was improved by 10.08% and 25.89%, and TUGT was decreased by 6.63% and 14.90%, respectively. However, there were no significant difference between the assessment results for one week and three months training （P 〉 0.05）. Conclusion： Based on medical treatment, the visual and auditory cues could significantly improve PD patients＇ motor function, such as the balance and gait performance.