远程与院内康复训练对帕金森病患者运动功能和生活质量的影响:回顾性队列研

Effects of Remote Versus In-hospital Rehabilitation Training on Motor Function and Quality of Life in Patients with Parkinson's Disease: A Retrospective Cohort Study

  • 摘要: 目的 比较远程康复训练与院内康复训练对改善帕金森病(Parkinson’s disease, PD) 患者运动功能和生活质量的疗效差异。方法 回顾性收集 2021 年 4 月至 2023年 12 月北京协和医院进行远程康复和院内康复的 PD 患者临床资料。两组患者均接受了每周 3 次, 连续 4 周的规律康复训练, 远程康复组在手机 APP 督导下进行居家康复训练, 院内康复组在院内康复治疗师指导下进行康复训练。治疗前后分别采用 Berg 平衡量表(Berg Balance Scale, BBS)、 计时起立行走试验(Timed Up&Go Test, TUGT)、 5 次起坐试验(Five Times Sit to Stand Test, FTSST)、 统一帕金森病评定量表(Unified Parkinson's Disease Rating Scale, UPDRS)-III、 可穿戴步态分析仪评估患者的运动功能; 采用 UPDRSII 和 39 项帕金森病生活质量问卷(Parkinson's Disease Questionnaire-39, PDQ-39) 评估患者的日常生活活动能力和生活质量。结果 共入选符合纳入和排除标准的 PD 患者 107 例, 其中远程康复组 59 例, 院内康复组 48 例。治疗前、 后远程康复组 UPDRS-Ⅲ分别为(18.20±9.22) 分和(15.34±7.82) 分; BBS 分别为(48.25±6.07) 分和(51.27±4.50) 分,组内差异均有统计学意义 (P<0.05) 。治疗前 、 后院内康复组 UPDRS-Ⅲ分别为(20.94±7.90) 分和(16.96±7.90) 分; BBS 分别为(45.85±6.04) 分和(51.44±3.84) 分,组内差异均有统计学意义(P 均<0.05)。治疗前后 BBS、 TUGT、 FTSST 和 PDQ-39 评分变化组间差异有统计学意义(P 均<0.05)。结论 远程康复和院内康复均可显著改善 PD 患者的运动功能和生活质量。院内康复在改善平衡功能、 身体活动功能和生活质量方面较远程康复的疗效更为突出。

     

    Abstract: Objective To compare the efficacy of remote rehabilitation training versus inhospital rehabilitation training in improving motor function and quality of life in patients with Parkinson’s disease (PD). Methods Clinical data of PD patients who underwent remote or in-hospital rehabilitation at Peking Union Medical College Hospital between April 2021 and December 2023 were retrospectively collected. Both groups received structured rehabilitation training three times per week for four consecutive weeks. The remote rehabilitation group performed home-based exercises supervised via a mobile app, while the in-hospital group underwent therapist-guided training in the hospital. Motor function was assessed before and after treatment using the Berg Balance Scale (BBS), Timed Up&Go Test (TUGT), Five Times Sit-to-Stand Test (FTSST), Unified Parkinson’s Disease Rating Scale Part III (UPDRS-III), and wearable gait analysis. Daily living activities and quality of life were evaluated using UPDRS-II and the 39-item Parkinson’s Disease Questionnaire (PDQ-39). Results A total of 107 eligible PD patients were enrolled, including 59 in the remote rehabilitation group and 48 in the in-hospital group. In the remote group, UPDRS-III scores improved from 18.20±9.22 to 15.34±7.82, and BBS scores increased from 48.25±6.07 to 51.27±4.50 (both P<0.05). In the in-hospital group, UPDRS-III scores decreased from 20.94±7.90 to 16.96±7.90, and BBS scores improved from 45.85±6.04 to 51.44±3.84 (all P<0.05). Between-group differences in pre-post changes were significant for BBS, TUGT, FTSST, and PDQ-39 scores (all P<0.05). Conclusion Both remote and in-hospital rehabilitation significantly improve motor function and quality of life in PD patients. However, in-hospital rehabilitation demonstrates superior efficacy in enhancing balance, physical mobility, and quality of life compared to remote rehabilitation.

     

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