《中国康复理论与实践》

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (7): 781-789.doi: 10.3969/j.issn.1006-9771.2025.07.005

• 循证研究 • 上一篇    下一篇

运动干预对帕金森病冻结步态效果的Meta分析

杜雯倩, 张旭, 陈继伟, 王兴, 朱昆()   

  1. 上海体育大学体育教育学院，上海市 200438
  • 收稿日期:2025-04-18 修回日期:2025-05-22 出版日期:2025-07-25 发布日期:2025-07-30
  • 通讯作者: 朱昆(1979-)，男，汉族，河南安阳市人，副教授，硕士研究生导师，主要研究方向：运动与健康促进。E-mail： zhukun@sus.edu.cn
  • 作者简介:杜雯倩(1999-)，女，汉族，山东泰安市人，硕士研究生，主要研究方向：运动与健康促进。
  • 基金资助:
    国家社会科学基金项目(22BTY076)

Effect of exercise on freezing of gait in Parkinson's disease: a meta-analysis

DU Wenqian, ZHANG Xu, CHEN Jiwei, WANG Xing, ZHU Kun()   

  1. School of Physical Education, Shanghai University of Sport, Shanghai 200438, China
  • Received:2025-04-18 Revised:2025-05-22 Published:2025-07-25 Online:2025-07-30
  • Contact: ZHU Kun, E-mail: zhukun@sus.edu.cn
  • Supported by:
    National Social Science Fund of China(22BTY076)

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摘要：

目的 系统评价运动干预对帕金森病冻结步态的改善效果。

方法 构建PICO架构，检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、维普和万方数据库，纳入有关运动干预对帕金森病冻结步态的随机对照试验，检索时限为建库至2025年3月。采用PEDro量表评估文献质量，采用Stata 17.0进行Meta分析，采用GRADE进行证据质量评价。

结果 共纳入12篇随机对照试验，涉及463例患者，PEDro量表评分5~8分。运动干预能显著降低帕金森患者冻结步态问卷(FOGQ)评分(SMD = -0.61, 95%CI -0.85~-0.36, P < 0.001)和统一帕金森病评估量表第三部分(UPDRSⅢ)评分(SMD = -0.84, 95%CI -1.27~-0.41, P < 0.001)。亚组分析显示，运动干预对年龄59~68岁、病程< 6年以及男性患者更有效；每次干预> 30 min，每周> 3次，持续> 8周的运动剂量效果更好；单纯步行训练可能效果不显著。运动改善FOGQ的GRADE为中级，改善UPDRSⅢ为低级。

结论 运动干预能改善帕金森病患者的冻结步态，年龄较轻、病程较短的男性患者效果更佳；推荐长周期(> 8周)、高频次(每周> 3次)、长时间(> 30 min)运动剂量以及综合运动策略。

关键词: 帕金森病, 运动, 冻结步态, Meta分析

Abstract:

Objective To evaluate the effect of exercise on freezing of gait in Parkinson's disease.

Methods After constructing a PICO framework, randomized controlled trials (RCTs) about exercise for freezing of gait in Parkinson's disease were systematically retrieved from Web of Science, PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data, from the establishment of the databases to March, 2025. The PEDro scale was used to evaluate the quality of literature, Stata 17.0 was used for meta-analysis, and GRADE was used to assess the evidence quality.

Results A total of twelve RCTs involving 463 patients were included, with PEDro scale scores of five to eight. Exercise improved the scores of Freezing of Gait Questionnaire (FOGQ) (SMD = -0.61, 95%CI -0.85~-0.36, P< 0.001) and Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ) (SMD = -0.84, 95%CI -1.27~-0.41, P< 0.001). Subgroup analysis revealed that the patients aged 59 to 68 years, the course of disease < six years, and male might get more benefit from exercise; exercise more than 30 minutes a time, more than three times a week, and lasting eight weeks or more might be better; and walking training alone might do less. GRADE was moderate for FOGQ, and low for UPDRSⅢ.

Conclusion Exercise may relieve freezing of gait in Parkinson's disease, especially for male, younger people and people with shorter course of disease. Long term exercise (more than eight weeks), long session duration (more than 30 minutes) and high frequencies (more than three times a week), and mulit-strategy were recommended.

Key words: Parkinson's disease, exercise, freezing of gait, meta-analysis

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