Home-based prescribed exercise improves balance-related activities in people with Parkinson's disease and has benefits similar to centre-based exercise: a systematic review

被引：75
作者：
Flynn, Allyson [1 ,2 ]
Allen, Natalie E. [1 ]
Dennis, Sarah [1 ,3 ]
Canning, Colleen G. [1 ]
Preston, Elisabeth [2 ]
机构：
[1] Univ Sydney, Fac Hlth Sci, Discipline Physiotherapy, Sydney, NSW, Australia
[2] Univ Canberra, Fac Hlth, Discipline Physiotherapy, Canberra, ACT, Australia
[3] South Western Sydney Local Hlth Dist, Sydney, NSW, Australia
来源：
JOURNAL OF PHYSIOTHERAPY | 2019年 / 65卷 / 04期
关键词：
Parkinson disease; Exercise; Home based; Systematic review; Rehabilitation; QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIAL; POSTURAL INSTABILITY; PREVENT FALLS; GO TEST; PROGRAM; GAIT; INDIVIDUALS; RELIABILITY; PERFORMANCE;
D O I：
10.1016/j.jphys.2019.08.003
中图分类号：
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];
学科分类号：
摘要：
Questions: In people with Parkinson's disease, does home-based prescribed exercise improve balance-related activities and quality of life compared with no intervention? Are the effects of home-based exercise similar to those of equivalent centre-based exercise? Design: Systematic review and meta-analysis of randomised and quasi-randomised controlled trials. Participants: Adults diagnosed with idiopathic Parkinson's disease. Intervention: Predominantly home-based prescribed exercise (defined as a minimum of two-thirds of the exercise being completed at home). The intervention had to primarily involve physical practice of exercises targeting gait and/or standing balance compared with either control (ie, usual care only, a sham intervention or no physiotherapy) or equivalent predominantly centre-based exercise. Outcome measures: The primary outcome was balance-related activities and the secondary outcomes were gait speed, Berg Balance Scale, Functional Reach test, and quality of life. Results: Sixteen trials met the inclusion criteria and all contributed to the meta-analyses. Twelve trials compared home-based prescribed exercise with control, and four trials compared home-based prescribed exercise with equivalent centre-based exercise. Home-based prescribed exercise improved balance-related activities (SMD 0.21, 95% CI 0.10 to 0.32) and gait speed (SMD 0.30, 95% CI 0.12 to 0.49), but not quality of life (SMD 0.11, 95% CI -0.01 to 0.23) compared with control. Home-based and centre-based exercise had similar effects on balance-related activities (SMD -0.04, 95% CI -0.36 to 0.27) and quality of life (SMD -0.08, 95% CI -0.41 to 0.24). Conclusion: Home-based prescribed exercise improves balance-related activities and gait speed in people with Parkinson's disease, and these improvements are similar to improvements with equivalent centre-based exercise. (C) 2019 Australian Physiotherapy Association. Published by Elsevier B.V.
引用
收藏
页码：189 / 199
页数：11
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