前庭康复对帕金森病患者平衡功能的影响

Vestibular rehabilitation improves the balance of persons with Parkinson′s disease

目的探讨前庭康复对帕金森病患者平衡功能的影响。方法将符合标准的61例帕金森病患者按随机数字表法分为治疗组(30例)和对照组(31例)。治疗组行前庭康复训练和防跌倒教育,前庭康复训练包括适应性训练、平衡和步态训练,每周训练6次,每次50~70 min,共治疗8周时间,而对照组仅行防跌倒教育。分别于治疗前和治疗8周后(治疗后),采用统一帕金森病评价量表第三部分(UPDRSⅢ)、Berg平衡量表(BBS)、起立-行走计时测验(TUGT)及39项帕金森病调查表(PDQ39)对2组患者进行疗效评价。结果治疗前,2组患者的UPDRSⅢ、BBS和PDQ39评分及TUGT值组间比较,差异均无统计学意义(P>0.05)。治疗后,治疗组的UPDRSⅢ评分[(24.53±8.93)分]和PDQ39评分[(36.52±10.37)分],较组内治疗前[(26.24±7.56)分和(37.23±11.14)分]改善不明显(P>0.05),且2组间治疗后同时间点比较,差异亦无统计学意义(P>0.05)。治疗后,治疗组患者的BBS评分[(51.70±8.47)分]和TUGT数值[(9.82±3.48)s]较组内治疗前[(42.68±12.52)分和(12.86±4.47)s]有明显改善,差异有统计学意义(P<0.05),且较对照组治疗后[(43.69±11.28)分和(12.46±3.32)s]改善更为明显(P<0.05)。结论前庭康复训练可以改善帕金森病患者的平衡功能和步行能力,可以作为辅助药物治疗的重要物理治疗手段。

Objective To explore the effect of vestibular rehabilitation on the balance function of patients with Parkinson′s disease. Methods Sixty-one patients with Parkinson′s disease were randomly divided into a treatment group of 30 and a control group of 31. Both groups were given the usual health education about fall prevention, while the treatment group was additionally provided with 50 to 70 minutes of vestibular rehabilitation training 6 times a week for 8 weeks. The training included the adaptability training, balance training and gait training. Before and after the treatment, both groups were evaluated with the unified Parkinson′s disease rating scale (part III)(UPDRS III), the Berg balance scale (BBS), the Timed Up and Go test (TUGT) and the 39-item Parkinson′s disease questionnaire (PDQ39). Results There were no significant differences in the average UPDRS III, BBS or PDQ39 scores nor in the average TUGT times between the two groups before the treatment. After the treatment there was still no significant difference in groups′ average UPDRS III and PDQ39 scores, but the average TUGT times and BBS scores of the treatment group were then significantly improved and significantly better than the control group′s averages. Conclusion Vestibular rehabilitation training can improve the balance and walking ability of those with Parkinson′s disease. It can serve as an important ancillary treatment to drug therapy.