目的 观察阈值压力负荷吸气肌训练对帕金森病患者平衡功能的影响。 方法 采用随机数字表法将帕金森病患者48例分为观察组和对照组，每组24例。对照组给予常规神经内科药物治疗和常规康复训练，观察组在此基础上使用阈值压力负荷训练器进行吸气肌训练。阈值压力负荷吸气肌训练每周训练5 d，连续训练8周。于治疗前和治疗8周后(治疗后)分别对2组患者进行吸气肌功能[包括超声评估膈肌的活动度和厚度，以及最大吸气压(MIP)]、平衡功能[包括躯干损伤量表(TIS)评分、Berg平衡量表(BBS)评分、姿势稳定极限(LOS)和计时起立-行走测试(TUGT)]和步行功能[包括10米步行测试(10MWT)和动态步态指数(DGI)]评定。 结果 治疗后，2组患者的膈肌活动度、厚度和MIP均较组内治疗前均明显改善，差异均有统计学意义( P<0.05)。观察组治疗后的膈肌活动度、吸气末厚度和MIP均显著优于对照组治疗后，差异均有统计学意义(P<0.05)。治疗后，2组患者的TIS评分、BBS评分、LOS和TUGT较组内治疗前均显著改善，差异均有统计学意义(P<0.05)。观察组治疗后的TIS评分、BBS评分、LOS和TUGT均显著优于对照组治疗后，差异均有统计学意义(P<0.05)。治疗后，2组患者的10MWT和DGI评分较组内治疗前均显著改善，差异均有统计学意义(P<0.05)。观察组治疗后的10MWT和DGI评分均显著优于对照组治疗后，差异均有统计学意义(P<0.05)。相关性分析显示，观察组治疗前、后的MIP差值与其TUGT差值(r＝－0.651)、10MWT差值(r＝－0.501)均呈显著负相关(P<0.01)。 结论 阈值压力负荷吸气肌训练联合常规康复治疗可显著改善帕金森病患者的吸气肌力量、膈肌活动度和厚度，从而进一步地改善患者的平衡功能和步行能力。 Objective To observe any effect of threshold pressure loaded inspiratory muscle training on the balance of persons with Parkinson′s disease (PD). Methods Forty-eight persons with PD were randomly divided into an observation group and a control group, each of 24. Both groups were given conventional neurological drug treatment and conventional rehabilitation training. The observation group additionally completed inspiratory muscle training using a threshold pressure load trainer, 5 days per week for 8 weeks. Before and after the treatment, both groups′ inspiratory muscle functioning was quantified using ultrasound to assess diaphragm mobility and thickness, and maximum inspiratory pressure (MIP). Balance was quantified using Trunk Injury Scale (TIS) scoring, the Berg Balance Scale (BBS), limits of stability (LOS), and the timed up and go test (TUGT). Walking was evaluated using the 10-metre walk test (10MWT) and the Dynamic Gait Index (DGI). Results After the treatment all of the indicators had improved significantly in both groups, on average, but those of the observation group were then significantly better. Correlation analysis showed that the difference in MIP of the observation group before and after treatment was significantly negatively correlated with the TUGT and 10MWT times. Conclusion Threshold pressure loaded inspiratory muscle training combined with conventional rehabilitation therapy significantly improves the inspiratory muscle strength, balance and walking of persons with PD.
Inspiratory muscle training can improve the breathing, balance and walking of persons with Parkinson′s disease
Objective To observe any effect of threshold pressure loaded inspiratory muscle training on the balance of persons with Parkinson′s disease (PD). Methods Forty-eight persons with PD were randomly divided into an observation group and a control group, each of 24. Both groups were given conventional neurological drug treatment and conventional rehabilitation training. The observation group additionally completed inspiratory muscle training using a threshold pressure load trainer, 5 days per week for 8 weeks. Before and after the treatment, both groups′ inspiratory muscle functioning was quantified using ultrasound to assess diaphragm mobility and thickness, and maximum inspiratory pressure (MIP). Balance was quantified using Trunk Injury Scale (TIS) scoring, the Berg Balance Scale (BBS), limits of stability (LOS), and the timed up and go test (TUGT). Walking was evaluated using the 10-metre walk test (10MWT) and the Dynamic Gait Index (DGI). Results After the treatment all of the indicators had improved significantly in both groups, on average, but those of the observation group were then significantly better. Correlation analysis showed that the difference in MIP of the observation group before and after treatment was significantly negatively correlated with the TUGT and 10MWT times. Conclusion Threshold pressure loaded inspiratory muscle training combined with conventional rehabilitation therapy significantly improves the inspiratory muscle strength, balance and walking of persons with PD.
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