摘要：

目的 探讨水中运动训练对帕金森病患者运动功能、平衡功能和行走能力的康复作用。 方法 共40 例原发性帕金森病患者随机接受常规陆上康复训练（陆上组，20 例）和水中运动训练（水中组，20 例），分别于训练前和训练8 周时采用统一帕金森病评价量表第三部分（UPDRSⅢ）评价运动功能、Berg 平衡量表（BBS）和起立?行计时走测验（TUGT）评价平衡功能、6 分钟步行试验（6MWT）和10 米步行试验（10MWT）评价行走能力。 结果 两组患者训练8 周时UPDRSⅢ评分（P = 0.000）和TUGT 时间（P =0.000）低于训练前，BBS 评分（P = 0.000）、6MWT 时间（P = 0.000）和10MWT 步速（P = 0.000）高于训练前；训练8 周时水中组患者UPDRSⅢ评分（P = 0.037）和TUGT 时间（P = 0.013）低于陆上组，BBS 评分高于陆上组（P = 0.018）。 结论 常规陆上康复训练和水中运动训练均可以改善帕金森病患者运动功能、平衡功能和行走能力，特别是在运动功能和平衡功能方面水中运动训练效果优于常规陆上康复训练。

关键词: 帕金森病, 运动障碍, 运动疗法, 康复

Abstract:

Objective  To explore the effect of water-based exercise on motor function, balance function and walking ability in patients with Parkinson's disease (PD).  Methods  Forty patients with primary PD were randomly divided into conventional land-based rehabilitation therapy group (land-based group, N = 20) and water-based exercise group (water-based group, N = 20). Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) was used to evaluate the patients' motor function. Berg Balance Scale (BBS) and Timed Up and Go Test (TUGT) were used to evaluate balance function. The 6-Minute Walk Test (6MWT) and 10-Meter Walk Test (10MWT) were used to evaluate walking ability. All the tests were carried out before and after 8-week training in 2 groups.  Results  Patients in both groups had a significant decrease on UPDRS Ⅲ score (P = 0.000), TUGT (P = 0.000) after training, while they had a significant increase on BBS score (P = 0.000), 6MWT (P = 0.000) and 10MWT (P = 0.000). The water-based group had significantly lower UPDRSⅢ score (P = 0.037), shorter TUGT (P = 0.013) and higher BBS score (P = 0.018) than those in land-based group after training.  Conclusions  Both conventional land-based training and water-based training had positive effect on motor function, balance function and walking ability in PD patients. The water-based training had more positive effect than land-based therapy on motor function and balance function.

Key words: Parkinson disease, Movement disorders, Exercise therapy, Rehabilitation