足底機械性刺激對巴金森氏病患者步態表現之療效：統合分析與系統性回顧

Effects of Plantar Mechanical Stimulation on Gait Performance in People With Parkinson's Disease: A Meta-Analysis and Systematic Review

吳彩瑛(Tsai-Ying Wu) ； 李哲瑜(Che-Yu Lee) ； 張雅涵(Ya-Han Chang) ； 王瑞瑤(Ray-Yau Wang) ； 楊雅如(Yea-Ru Yang)

《物理治療》 46卷1期 (2021/03) Pp. 25-40

https://doi.org/10.6215/FJPT.202103_46(1).0003

摘要

背景和目的：巴金森氏病患者經常有步態障礙問題，後續可能會導致失能、增加跌倒風險以及影響其生活品質。依據先前研究指出，巴金森氏病患者之周邊感覺異常或感覺動作整合異常與步態表現有相關性。足底機械性刺激是一種施加感覺刺激於足底的介入形式，藉由感覺刺激影響巴金森氏病患者之步態表現。本研究採用統合分析與系統性回顧以探討足底機械性刺激介入對於巴金森氏病患者步態表現的改善效果。方法：本研究搜尋相關電子資料庫，納入1976年12月1日至2020年3月31日前的隨機對照試驗。使用皮卓量表與2011年版牛津實證醫學中心證據等級分析納入文獻的品質與建議等級。若有2篇以上文獻使用相同的步態測試項目，其單次介入的立即性效果以及多次介入計畫的累積性效果則使用Review Manager Version 5.3軟體進行統合分析。結果：本研究共納入5 篇文獻進行統合分析和文獻回顧，統合分析結果顯示，巴金森氏病患者經過足底機械性刺激介入後，於行走速度之累積性效果（mean difference = 0.54, 95% confidence interval: 0.02～1.07, p = 0.04）有顯著的改善。根據系統性文獻回顧可知，足底機械性刺激亦有改善功能性活動表現的效果。結論：多次的足底機械性刺激可顯著改善巴金森氏病患者的行走速度。

關鍵字

巴金森氏病 ； 足底機械性刺激 ； 步態表現 ； 行走速度 ； 步幅

並列摘要

Background and Purpose: Many people with Parkinson's disease (PD) have gait abnormalities, which may lead to increased risk of fall and disability and affect quality of life. Previous studies have demonstrated a correlation between abnormal peripheral sensory or sensory-motor integration and gait performance in patients with PD. Plantar mechanical stimulation is a form of intervention that applies sensory stimulation to the sole of the foot to improve gait performance in people with PD. The purpose of this study is to use a meta-analytical approach to assess the effects of plantar mechanical stimulation on gait performance and systematically review the evidence of plantar mechanical stimulation in people with PD. Methods: A systematic search of the randomized controlled trials from December 1, 1976 to March 31, 2020 was conducted. The immediate effect after one session and the cumulative effect after multiple sessions of intervention on gait performance were both investigated. The quality of eligible studies was evaluated using Physiotherapy Evidence Database Scale and Oxford classification. Meta-analysis was conducted using Review Manager Version 5.3 software. Results: Five studies were included in meta-analysis and systematic review. The results of our meta-analysis showed that plantar mechanical stimulation significantly improved gait velocity (mean difference = 0.54, 95% confidence interval: 0.02 ~ 1.07, p = 0.04) after multiple sessions of intervention, which has accumulated effects on gait velocity in people with PD. According to the results of systematic review, plantar mechanical stimulation also improved functional performance. Conclusion: Plantar mechanical stimulation showed accumulated effects on gait speed in people with PD.

並列關鍵字

Parkinson's disease ； Plantar mechanical stimulation ； Gait performance ； Velocity ； Stride length