多种运动干预措施对帕金森病人平衡功能影响的网状Meta分析

Effects of multiple exercise interventions on balance function in patients with Parkinson′s disease:a network Meta-analysis

目的:采用网状Meta分析方法比较多种运动干预措施对帕金森病人平衡功能的影响。方法:计算机检索Web of Science、PubMed、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网、万方等数据库,搜集不同干预措施对帕金森病人平衡功能影响的随机对照试验,检索时限均从建库至2020年3月10日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用ADDIS及R软件进行数据分析,采用Stata软件进行图形绘制。结果:共纳入32项随机对照试验,涉及1352例帕金森病人。网状Meta分析结果显示,太极拳训练、平衡训练、抗阻训练、机器人辅助步态训练、北欧步行训练、阿根廷探戈、虚拟现实训练、前庭康复训练、跑步机训练、华尔兹对帕金森病人的平衡功能优于常规康复措施,差异均有统计学意义(P<0.05);根据ADDIS排序结果,前庭康复训练在改善帕金森病人平衡功能方面优于其他运动干预方案。结论:现有证据表明前庭康复训练是改善帕金森病人平衡功能的最优运动干预措施。受所纳入文献的数量及质量的影响,上述结论需在今后研究中得到验证。

Objectives:To compare the effects of multiple exercise interventions on balance function in patients with Parkinson′s disease by taking a network Meta-analysis.Methods:Randomized controlled trials on effects of different interventions on balance function in patients with Parkinson′s disease,were retrieved from Web of Science,PubMed,EMbase,the Cochrane Library,CBM,CNKI and WanFang database.The retrieval time was from inception to March 10,2020.Screening of literature,extracting of data,and assessment of the risk of bias of including of studies were conducte by two reviewers independently.ADDIS and R softwares were used for data analysis,Stata software was used for graphics drawing.Results:Totally 32 randomized controlled trials were included,involving 1352 patients with Parkinson′s disease.The network Meta-analysis showed that Tai Chi exercise,balance training,resistance training,Robot-assisted gait training,Nordic walking intervention,Argentine tango,virtual reality training,vestibular rehabilitation training,treadmill training,waltz were significantly more effective than routine rehabilitation measures in improving balance in patients with Parkinson′s disease.There were statistical differences(P<0.05).According to the ranking results of ADDIS,vestibular rehabilitation training was superior than other exercise interventions in improving the balance function in patients with Parkinson′s disease.Conclusion:Current evidences shows that vestibular rehabilitation training is an optimal exercise intervention to improve balance in patients with Parkinson′s disease.Due to the limitation of the quantity and quality of included studies,the conclusion of this study need to be confirmed thorgh more and higher quality researches in future.