摘要
Abstract
Objective To systematically evaluate the effect of exercise interventions on respiratory function,cough ability and swal-lowing function in patients with Parkinson's disease,and to compare the efficacy of different types of exercise in-terventions.
Methods After constructing a PICO framework,randomized controlled trials(RCT)investigating the effects of exercise on respiratory function in Parkinson's disease were retrieved from Web of Science,PubMed,Cochrane Library,Embase,CNKI,Wanfang Data,VIP and CBM databases from the establishment of the databases to July 25th,2025.The risk of bias was assessed using the Cochrane Risk of Bias tool 5.1.0 and PEDro scale.RevMan 5.3 was used to create risk of bias graphs,and Stata 17.0 was used for meta-analysis.
Results A total of eleven RCT involving 471 patients were included,with PEDro scale score of five to eight.Exercise in-terventions significantly improved forced vital capacity(FVC)(MD=0.42,95%CI 0.27 to 0.58,P<0.001),forced expiratory volume in first second(MD=0.32,95%CI 0.24 to 0.39,P<0.001),slow vital capacity(MD=0.80,95%CI 0.68 to 0.93,P<0.001),maximal inspiratory pressure(MD=11.53,95%CI 7.45 to 15.60,P<0.001),maximal expiratory pressure(MEP)(MD=16.75,95%CI 11.90 to 21.60,P<0.001),and peak expiratory flow(MD=55.77,95%CI 49.87 to 61.66,P<0.001)in patients with Parkinson's disease.Respiratory muscle training(RMT)significantly improved reflex peak cough flow(MD=3.51,95%CI 2.40 to 4.61,P<0.001)and voluntary peak cough flow(MD=3.09,95%CI 2.12 to 4.06,P<0.001).Subgroup analysis revealed that RMT was superior to non-ventilatory specific exercise(NVS)in improving MEP(P<0.05),whereas NVS was superi-or to RMT in improving FVC(P<0.05).
Conclusion Exercise interventions can effectively improve respiratory function in patients with Parkinson's disease.NVS shows better efficacy in improving pulmonary function,while RMT can enhance cough ability,with more significant effect on respiratory muscle strength.关键词
帕金森病/运动/呼吸功能/Meta分析Key words
Parkinson's disease/exercise/respiratory function/meta-analysis分类
医药卫生