漸進式阻力訓練對巴金森氏症患者改善身體活動表現之效益

The effect of progressive resistance training on improvements of physical performance in patients with Parkinson's disease

王建睎(Jian-Xi Wang) ； 劉宏文(Hung-Wen Liu) ； 何仁育(Jen-Yu Ho)

《中華體育季刊》 31卷2期 (2017/06) Pp. 143-152

https://doi.org/10.3966/102473002017063102006

摘要

巴金森氏症 (Parkinson's disease, PD)，是中老年人可能會遇到的中樞神經系統 (central nervous system, CNS) 退化性疾病。PD 患者主要病徵為出現靜止顫抖、肌肉僵硬、動作遲緩、步態不穩等動作障礙，會進一步影響日常生活中的身體活動能力，降低生活品質。在醫療上，患者較常使用且藥效較好的左旋多巴 (levodopa) 藥物，雖然在病理治療上短期能穩定患者的動作障礙，但藥物會隨著攝取劑量的累積，緩慢出現噁心、頭暈、頭痛、認知功能衰退等副作用的症狀。近年來，多數研究指出，透過漸進式阻力訓練 (progressive resistance training, PRT) 除了能提升患者肌肉適能以外，也能改善患者在步態行走時的平衡能力、步頻以及增加步距，進而減緩患者症狀，改善身體活動表現。因此，本文藉由文獻回顧來探討PRT 運動對PD 患者身體活動表現之效益，並透過文獻的統整，提出有效的PRT 運動原則與建議處方，以每週進行2-3 天的訓練頻率、每組動作訓練2-3 組、每組反覆8 至12 次，並持續訓練10 週以上，能改善PD 患者身體活動表現與生活品質，給予提供相關運動指導員作為參考依據。

關鍵字

神經退化性疾病 ； 肌肉適能 ； 重量訓練 ； 動作障礙

並列摘要

Parkinson's disease (PD) is a progressive, degenerative disorder of the central nervous system commonly seen in the elderly. The most common symptoms of PD include rest tremor, muscle rigidity, bradykinesia and instability of gait. These symptoms may impair their daily activity performance, and therefore lower the life quality. In medication, although the short-term used of levodopa, which is commonly used by PD patients, can significantly improve the patient's clinical symptoms, but cumulative doses of levodopa may cause side effects such as nausea, dizziness, headache and cognitive failure. In recent years, most studies have found that progressive resistance training (PRT) can be used to increase PD patient's muscular fitness, to improve balance, stride frequency and length during gait cycle, and to improve the physical performance. Hence, the purpose of this review aimed to examine the effect of the PRT on improvements of physical performance in PD patients through literature review and to provide the effective prescription for PD patients to improve their physical performance and the quality of life. The PRT which prescribed as follows, 2-3 days per week, 2-3 sets per session, 8-12 repetitions, and lasted for 10 weeks, could significantly improve physical performance and quality of life in PD patients. The suggested PRT prescription can be used as reference for exercise instructors.

並列關鍵字

neurodegenerative disease ； muscular fitness ； weight training ； dyskinesias

參考文獻

行政院衛生福利部統計處 (2016)。中華民國100年至104 年台灣地區帕金森氏症死亡人口狀況調查報告。臺北市：作者。

Alty, E. J.,Clissold, B. G.,McColl, C, D.,Reardon, K. A.,Shiff, M.,Kempster, P. A.(2009).Longitudinal study of the levodopa motor response in Parkinson's disease: Relationship between cognitive decline and motor function.Movement Disorders.24(16),2337-2343.

Barbosa, M. T.,Caramelli, P.,Maia, D. P.,Cunningham, M. C. Q.,Guerra, H. L.,Lima-Costa, M. F.,Cardoso, F.(2006).Parkinsonism and Parkinson's disease in the elderly: A community-based survey in Brazil (the Bambui Study).Movement Disorders.21(6),800-808.

Benabid, A. L.,Chabardes, S.,Mitrofanis, J.,Pollak, P.(2009).Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.The Lancet Neurology.8(1),67-81.

Bloomer, R. J.,Schilling, B. K.,Karlage, R. E.,Ledoux, M. S.,Pfeiffer, R. F.,Callegari, J.(2008).Effect of resistance training on blood oxidative stress in Parkinson disease.Medicine& Science in Sports & Exercise.40(8),1385-1389.