Ítem
Acceso Abierto

Ejercicio y resultados clínicos en pacientes con enfermedad de Parkinson: una revisión sistemática y metaanálisis

dc.contributor.advisorMeneses Echávez, José Francisco
dc.creatorReyes, Alexander
dc.creator.degreeMagíster en Ciencias Biomédicas
dc.date.accessioned2016-05-04T19:17:26Z
dc.date.available2016-05-04T19:17:26Z
dc.date.created2015-02-06
dc.date.issued2015
dc.descriptionAntecedentes. La enfermedad de Parkinson (EP) es la segunda enfermedad neurodegenerativa más común en el mundo, la cual afecta el componente físico, psicológico y social de los individuos que la padecen. Numerosos estudios han abordado los beneficios de diferentes programas de ejercicio, llegando a ser una estrategia no-farmacológica efectiva para aminorar el deterioro funcional de los pacientes con EP. Objetivo. Determinar los efectos de las diferentes modalidades de ejercicio físico en los principales desenlaces clínicos en pacientes con EP. Métodos. Se consultaron las bases de datos MEDLINE, EMBASE, Scopus, CENTRAL y PEDro desde febrero de 1990 hasta febrero de 2014 para identificar Ensayos Clínicos Aleatorizados (ECA) publicados. Además, se examinaron las listas de referencias de otras revisiones y de estudios identificados. La extracción de datos se realizó por dos autores independientes. Se empleó un modelo de efectos aleatorios en presencia de heterogeneidad estadística (I2>50%). El sesgo de publicación fue evaluado mediante el gráfico de embudo. Resultados: Un total de 18 estudios fueron incluidos. Se encontraron diferencias estadísticamente significativas en las intervenciones con ejercicio y las siguientes medidas de resultado, severidad de los síntomas motores (MDS-UPDRS) DME 1.44, IC 95% [-2.09 a -0.78] (p<0.001) I2= 87,9% y el equilibrio DME 0,52 IC 95% [0,30 a 0,74] (p<0.001) I2= 85,6%. En el análisis de subgrupos en la modalidad de ejercicio aeróbico, en MDS-UPDRS DME -1,28, IC 95% [-1,98 a -0,59] (p<0.001), 3 calidad de vida DME -1,91 IC 95% [-2,76 a -1,07] (p<0.001), equilibrio DME 0,54 IC 95% [0,31 a 0,77] (p<0.001), 10-m WT DME 0,15 IC 95% [0,06 a 0,25] (p<0.001) y Vo2 máximo DME -1,09 IC 95% [-1,31 a -0,88] (p=0.001), 6MWT DME 40,46 IC 95% [11,28 a 69,65] (p=0.007). Conclusiones: El ejercicio aeróbico produjo mejoras significativas en MDS UPDRS, equilibrio, calidad de vida, 10-m WT y y Vo2 máximo; mientras que el ejercicio combinado mejoró la fuerza.spa
dc.description.abstractBackground: Parkinson is the second most common neurodegenerative disease worldwide. Physical exercise has been considered as an effective non pharmacological strategy to improve functional impairment in patients with Parkinson. Objective: To determine the effects of the different modalities of physical exercise on the main clinical related outcomes in patients with Parkinson Disease (PD). Methods: MEDLINE, EMBASE, Scopus, CENTRAL and PEDro databases were searched up since February 1990 to February 2014 to identify randomized controlled trials (RTC’s). Further, reference lists and others related reviews were also checked. Data extraction was conducted by two independent authors. A random-effects model of meta-analysis was undertaken in presence of statistical heterogeneity (I2>50%). Publication bias was estimated using a funnel plot and the Egger’s test (p<0.05). Results: A total of 18 studies were included. Physical exercise produced significant improvements on motor symptoms severity (MDS-UPDRS) (SMD= 1.44, 95% CI -2.09 to -0.78; p<0.001) (I2= 87.9%) and balance (SMD= 0.52, 95%CI 0.30 to 0.74; p<0.001) (I2= 85.6%). In the subgroup analyses, aerobic exercise produced significant benefits on motor symptoms severity (SMD= -1.28, 95%CI 1.98 to -0.59; p<0.001), quality of life (SMD= -1.91, 95%CI -2.76 to -1.07; p<0.001), balance (SMD= 0.54, 95%CI 0.31 to 0.77; p<0.001), Vo2 max (SMD= 1.09, 95%CI -1.31 to -0.88; p=0.001) and 6 minutes walking test (SMD= 40.46, 95%CI 11.28 to 69.65; p=0.007). Conclusion: Aerobic exercise improves motor symptoms severity, balance, quality of life and aerobic capacity in patients with PD. Resistance training provides benefits on the muscular strength of these patients.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_11958
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/11958
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de medicinaspa
dc.publisher.programMaestría en Actividad Física y Saludspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.ccAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.source.bibliographicCitationAbrantes A, Friedman J, Brown R, Strong D, Desaulniers J, Riebe D, et al. Physical activity and neuropsychiatric symptoms of Parkinson disease J Geriatr Psychiatry Neurol, 2012, 25(3):138-145.
dc.source.bibliographicCitationDexter D, Jenner P. Parkinson disease: from pathology to molecular disease mechanisms. Free Radic Biol Med, 2013, (62):132-144.
dc.source.bibliographicCitationSamii A, Nutt J, Ransom B. Parkinson´s disease. Lancet, 2004, 363, 1783 93.
dc.source.bibliographicCitationDiazgranados J, Chan L, Gómez L, Lozano A, Ramírez M. Descripción de la población de pacientes con enfermedad de Parkinson en un centro médico neurológico en la ciudad de Cali, Colombia, 2011, Acta Neurológica Colombiana, 27 (4).
dc.source.bibliographicCitationGallo P, Ewing C. Parkinson's disease: A comprehensive approach to exercise prescription for the health fitness professional. ACSMs Health Fit J, 2011, 15(4): 8-17.
dc.source.bibliographicCitationKaufmann H, Goldstein D. Autonomic dysfunction in Parkinson disease, Handb Clin Neurol, 2013 (117): 259-78.
dc.source.bibliographicCitationCheng K, Lin W, Chang W, Lin T, Tsai N, Kung C, et al. Factors associated with fall-related fractures in Parkinson's disease. Parkinsonism Relat Disord, 2014, 20(1):88-92.
dc.source.bibliographicCitationKeus S, Munneke M, Nijkrake M, Kwakkel G, Bloem B. Physical therapy in Parkinson's Disease: evolution and future challenges. Mov Disord, 2013, 24(1): 1-14.
dc.source.bibliographicCitationMatsudo S, Matsudo V. Actividad física y obesidad, prevención y tratamiento. Brasil: Midiograf; 2008.
dc.source.bibliographicCitationCox R. Psicología del deporte, conceptos y aplicaciones. Editorial Médica Panamericana: España; 2009.
dc.source.bibliographicCitationGobbi L, Oliveira-Ferreira M, Caetano M, Lirani-Silva E, Barbieri F, Gobbi S, et al. Exercise programs improve mobility and balance in people with Parkinson's disease. Parkinsonism Relat Disord, 2009, 15(Suppl. 3): 49-52.
dc.source.bibliographicCitationTomlinson C, Patel S, Meek C, Herd C, Clarke C, Ives N, et al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database Syst Rev, 2013, 9CD002817.
dc.source.bibliographicCitationRidgel A, Vitek J, Alberts J. Forced, not voluntary, exercise Improves motor function in Parkinson’s disease patients. Neurorehabil Neural Repair, 2009, 23 (6):600-608.
dc.source.bibliographicCitationAlberts J, Linder S, Penko A, Lowe M, Phillips M. It is not about the bike, it is about the pedaling: forced exercise and Parkinson’s Disease, 2011, Exerc Sport Sci Rev 39(4): 177-186.
dc.source.bibliographicCitationCotman C, Berchtold N, Christie L. Review: Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends Neurosci, 2007, 30(9): 30464-472.
dc.source.bibliographicCitationSmidt N, de Vet H, Bouter L, Dekker J. Effectiveness of exercise therapy: A best-evidence summary of systematic reviews. Aust J Physiother, 2005, 51(2): 71-85.
dc.source.bibliographicCitationZigmond M, Cameron J, Hoffer B, Smeyne R. Neurorestoration by physical exercise: moving forward. Parkinsonism Relat Disord, 2012, 18(SUPPL. 1): S147-S150.
dc.source.bibliographicCitationLiberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP et al. The PRISMA statement for reporting systematic reviews and meta analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 2009, 339: b2700
dc.source.bibliographicCitationde Morton N. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother, 2009, 55(2): 129-133
dc.source.bibliographicCitationAmerican College of Sports Medicine. ACSM´s guidelines for exercise testing and prescription. U.S.A: Lippincott Williams y Wilkins; 2010.
dc.source.bibliographicCitation. Higgins JP & Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002,15;21(11):1539-58.
dc.source.bibliographicCitationCentro Cochrane Iberoamericano, traductores. Manual Cochrane de Revisiones Sistemáticas de Intervenciones, versión 5.1.0 [actualizada en marzo de 2011] [Internet]. Barcelona: Centro Cochrane Iberoamericano; 2012. Disponible en http://www.cochrane.es/?q=es/node/269
dc.source.bibliographicCitationSchenkman M, Hall D, Baron A, Mettler P, Kohrt W, Schwartz R. Exercise for people in early- or mid-stage Parkinson disease: a 16-month randomized controlled trial. Phys Ther, 2012, 92(11):1395-1410.
dc.source.bibliographicCitationCarda S, Invernizzi M, Baricich A, Comi C, Cisari C, Croquelois A. Robotic gait training is not superior to conventional treadmill training in Parkinson disease: A single-blind randomized controlled trial. Neurorehabil Neural Repair, 2012, 26(9): 1027-1034.
dc.source.bibliographicCitationCanning C, Allen N, Dean C, Goh L, Fung V. Home-based treadmill training for individuals with Parkinson's disease: a randomized controlled pilot trial. Clin Rehabil, 2012, 26(9):817-826.
dc.source.bibliographicCitationPicelli A, Melotti C, Origano F, Neri R, Smania N, Waldner A. Robot assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson's disease: a randomized controlled trial, Parkinsonism Relat Disord, 2013, 19(6): 605-610.
dc.source.bibliographicCitationHackney M, Earhart G. Health-related quality of life and alternative forms of exercise in Parkinson disease. Parkinsonism Relat Disord, 2009, 15(9): 644 648.
dc.source.bibliographicCitationKurtais Y, Kutlay S, Tur B, Gok H, Akbostanci C. Does treadmill training improve lower-extremity tasks in Parkinson disease? A randomized controlled trial. Clin J Sport Med, 2008, 18(3): 289-291.
dc.source.bibliographicCitationFisher B, Salem G, Song J, Lin C, Yip J, Wu A, et al. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's Disease. Arch Phys Med Rehabil, 2008, 89(7): 1221-1229.
dc.source.bibliographicCitationHackney M, Kantorovich S, Levin R, Earhart G. Effects of tango on functional mobility in Parkinson's disease: a preliminary study. J Neurol Phys Ther, 2007, 31(4): 173.
dc.source.bibliographicCitationCakit B, Saracoglu M, Genc H, Erdem H, Inan L. The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease. Clin Rehabil, 2007, 21(8):698-705.
dc.source.bibliographicCitationMorris M, Iansek R, Kirkwood B. A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease. Mov Disord, 2009, 24(1): 64-71.
dc.source.bibliographicCitationAshburn A, Fazakarley L, McLellan L, Fitton C, Ballinger C, Pickering R. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's disease. J Neurol Neurosurg Psychiatry, 2007, 78(7): 678-684.
dc.source.bibliographicCitationHirsch M, Toole T, Rider R, Maitland C. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson's disease. Arch Phys Med Rehabil, 2003, 84(8): 1109-1117.
dc.source.bibliographicCitationDiFrancisco-Donoghue J, Werner W, Rabin E, Fazzini E, Lamberg E, Elokda A. Effects of exercise and b vitamins on homocysteine and glutathione in Parkinson's disease: A randomized trial. Neurodegener Dis, 2012, 10(1-4): 127-134.
dc.source.bibliographicCitationGoodwin V, Richards S, Campbell J, Henley W, Ewings P, Taylor A. An exercise intervention to prevent falls in people with Parkinson's disease: A pragmatic randomized controlled trial. J Neurol Neurosurg Psychiatry, 2011, 82(11): 1232-1238.
dc.source.bibliographicCitationLi F, Fitzgerald K, Stock R, Harmer P, Galver J, Batya S, et al. Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med, 2012, 366(6): 511-519.
dc.source.bibliographicCitationCombs S, Diehl M, Chrzastowski C, Didrick N, McCoin, B, Mox, N, et al. Community-based group exercise for persons with Parkinson disease: a randomized controlled trial. NeuroRehabilitation, 2013, 32(1):117-124.
dc.source.bibliographicCitationAllen N, Canning C, O'Rourke S, Murray S, Sherrington C, Fung V, et al. The effects of an exercise program on fall risk factors in people with Parkinson's disease: a randomized controlled trial. Mov Disord, 2010, 25(9): 1217-1225.
dc.source.bibliographicCitationPoliakoff E, Galpin A, Mcdonald K, Kellett M, Dick J, Hayes S, et al. The effect of gym training on multiple outcomes in Parkinson's disease: a pilot randomized waiting-list controlled trial. NeuroRehabilitation, 2013, 32(1): 125-134.
dc.source.bibliographicCitationGoodwin V, Richards S, Taylor R, Taylor A, Campbell J. The effectiveness of exercise interventions for people with Parkinson’s disease: a systematic review and meta-analysis, Mov Disord 2008, 23(5): 631–640.
dc.source.bibliographicCitationde Goede CJ, Keus SH, Kwakkel G, Wagenaar R. The effects of physical therapy in Parkinson’s disease: a research synthesis, Arch Phys Med Rehabil 2001; 82:509-15.
dc.source.bibliographicCitationSchilling B, Pfeiffer R, LeDoux M, Karlage R, Bloomer R, Falvo M. Effects of moderate-volume, high-load lower-body resistance training on strength and function in persons with Parkinson's disease: a pilot study. Parkinson's Disease, 2010; 1-6.
dc.source.bibliographicCitationDibble LE, Hale TF, Marcus RL, Gerber JP, LaStayo PC. High intensity eccentric resistance training decreases bradykinesia and improves Quality Of Life in persons with Parkinson's disease: a preliminary study. Parkinsonism Relat Disord. 2009, 15(10):752-7.
dc.source.bibliographicCitationDeane K, Jones D, Ellis-Hill C, Clarke C, Playford E, Ben-Shlomo Y. Physiotherapy for Parkinson’s disease: a comparison of techniques. Cochrane Database Syst Rev, 2009; Issue 1
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectEnfermedad idiopática de Parkinsonspa
dc.subjectEjerciciospa
dc.subjectRevisión sistemáticaspa
dc.subjectMeta análisisspa
dc.subject.ddcEnfermedades
dc.subject.decsEnsayos clínicos -- diagnósticospa
dc.subject.decsEnfermedad de Parkinson -- prevención primariaspa
dc.subject.keywordParkinson diseaseeng
dc.subject.keywordPhysical exerciseeng
dc.subject.keywordSystematic revieweng
dc.subject.keywordmeta analysiseng
dc.subject.lembEnfermedad de Parkinsonspa
dc.titleEjercicio y resultados clínicos en pacientes con enfermedad de Parkinson: una revisión sistemática y metaanálisisspa
dc.typemasterThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTesis de maestríaspa
Archivos
Bloque original
Mostrando1 - 1 de 1
Cargando...
Miniatura
Nombre:
METAANALISIS PARKINSON.pdf
Tamaño:
708.46 KB
Formato:
Adobe Portable Document Format
Descripción: