水中运动对帕金森病患者下肢肢体功能影响的Meta分析

Effects of water-based exercise on lower limb function in patients with Parkinson’s disease:a Meta-analysis

目的系统评价水中运动对帕金森病患者下肢肢体功能和生活质量的影响。方法计算机检索Web of Science、PubMed、Embase、Cochrane Library、中国生物医学文献数据库、中国知网、万方等数据库,检索关于水中运动对帕金森病患者影响的随机对照试验,检索时限均为从建库至2020年4月10日。由2名研究者按纳入与排除标准独立筛选文献、提取资料、评估文献质量,并采用RevMan 5.3进行Meta分析。结果共纳入10篇文献,总计318例帕金森病患者。Meta分析结果显示,与常规物理治疗相比,水中运动能显著改善帕金森病患者的平衡功能[MD=2.92,95%CI(1.07,4.77),P=0.002],步行功能[MD=-1.37,95%CI(-2.42,-0.33),P=0.010],提高患者的生活质量[MD=-2.71,95%CI(-0.50,-0.02),P=0.04],但在改善帕金森病患者下肢肌力[MD=-2.05,95%CI(-4.70,0.59),P=0.13]和其他运动功能[MD=-1.50,95%CI(-3.70,0.69),P=0.18]方面,差异无统计学意义。结论与常规物理治疗相比,水中运动可明显改善帕金森病患者的平衡功能、步态功能和生活质量,但在改善下肢肌力和运动功能方面效果不显著,仍需更多高质量的研究进一步论证。

Objective To systematically evaluate the effect of water-based exercise on lower limb function and quality of life in patients with Parkinson’s disease. Methods A systematic search of Web of Science,PubMed,EMBASE,the Cochrane Library,CNKI,WanFang Data and CBM databases was carried out to collect randomized controlled trials on water-based exercise for Parkinson’s disease from inception to April,2020. 2 reviewers independently screened the literature according to inclusion and exclusion criteria,extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. Results Totally 10 RCTs involving 318 patients were included. The results of Meta-analysis showed that water-based exercise was superior to the conventional physical therapy in balance function [MD =2.92,95% CI(1.07,4.77),P =0.002],gait function [MD=-1.37,95%CI(-2.42,-0.33),P=0.010] and quality of life[MD=-2.71,95%CI(-0.50,-0.02),P=0.04].However,there was no statistically significant difference in the improvement of lower limb muscle strength[MD =-2.05,95%CI(-4.70,0.59),P=0.13] and motor function [MD=-1.50,95%CI(-3.70,0.69),P=0.18] in Parkinson’s patients. Conclusion Compared with the conventional physical therapy,water-based exercise can improve the balance function,gait function and quality of life of Parkinson’s patients significantly,but it has no significant effect on the improvement of lower limb muscle strength and motor function. Due to the limitation of the quantity and quality of the study,the conclusion of this study needs to be confirmed by further high quality research.