Innovative technology-based interventions in Parkinson's disease: A systematic review and meta-analysis

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY

Annals of Clinical and Translational Neurology Pub Date : 2024-09-05 DOI:10.1002/acn3.52160

Chun En Yau, Eric Chi Kiat Ho, Natasha Yixuan Ong, Clifton Joon Keong Loh, Aaron Shengting Mai, Eng-King Tan

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引用次数: 0

Abstract

Objective

Novel technology-based interventions have the potential to improve motor symptoms and gait in Parkinson's disease (PD). Promising treatments include virtual-reality (VR) training, robotic assistance, and biofeedback. Their effectiveness remains unclear, and thus, we conducted a Bayesian network meta-analysis.

Methods

We searched the Medline, Embase, Cochrane CENTRAL, and Clinicaltrials.gov databases until 2 April 2024 and only included randomized controlled trials. Outcomes included changes in UPDRS-III/MDS-UPDRS-III score, stride length, 10-meter walk test (10MWT), timed up-and-go (TUG) test, balance scale scores and quality-of-life (QoL) scores. Results were reported as mean differences (MD) or standardized mean differences (SMD), with 95% credible intervals (95% CrI).

Results

Fifty-one randomized controlled trials with 2095 patients were included. For UPDRS (motor outcome), all interventions had similar efficacies. VR intervention was the most effective in improving TUG compared with control (MD: −4.36, 95% CrI: −8.57, −0.35), outperforming robotic, exercise, and proprioceptive interventions. Proprioceptive intervention significantly improved stride length compared to control intervention (MD: 0.11 m, 95% CrI: 0.03, 0.19), outperforming VR, robotic and exercise interventions. Virtual reality improved balance scale scores significantly compared to exercise intervention (SMD: 0.75, 95% CrI: 0.12, 1.39) and control intervention (SMD: 1.42, 95% CrI: 0.06, 2.77). Virtual reality intervention significantly improved QoL scores compared to control intervention (SMD: −0.95, 95% CrI: −1.43, −0.52), outperforming Internet-based interventions.

Interpretation

VR-based and proprioceptive interventions were the most promising interventions, consistently ranking as the top treatment choices for most outcomes. Their use in clinical practice could be helpful in managing motor symptoms and QoL in PD.

Abstract Image

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帕金森病的创新技术干预：系统回顾和荟萃分析。

目的：基于新技术的干预措施有望改善帕金森病（PD）患者的运动症状和步态。有前景的治疗方法包括虚拟现实（VR）训练、机器人辅助和生物反馈。这些疗法的效果尚不明确，因此我们进行了一项贝叶斯网络荟萃分析：我们检索了 Medline、Embase、Cochrane CENTRAL 和 Clinicaltrials.gov 数据库，直至 2024 年 4 月 2 日，只纳入了随机对照试验。研究结果包括UPDRS-III/MDS-UPDRS-III评分、步幅、10米步行测试（10MWT）、定时起立行走（TUG）测试、平衡量表评分和生活质量（QoL）评分的变化。结果以平均差（MD）或标准化平均差（SMD）以及 95% 可信区间（95% CrI）报告：结果：共纳入51项随机对照试验，2095名患者。就UPDRS（运动结果）而言，所有干预措施的疗效相似。与对照组相比，VR干预在改善TUG方面最为有效（MD：-4.36，95% CrI：-8.57，-0.35），优于机器人、运动和本体感觉干预。与对照组干预相比，本体感觉干预明显改善了步长（MD：0.11 米，95% CrI：0.03，0.19），优于虚拟现实、机器人和运动干预。与运动干预（SMD：0.75，95% CrI：0.12，1.39）和对照干预（SMD：1.42，95% CrI：0.06，2.77）相比，虚拟现实显著改善了平衡量表评分。与对照干预相比，虚拟现实干预能明显改善 QoL 评分（SMD：-0.95，95% CrI：-1.43，-0.52），优于基于互联网的干预：基于虚拟现实的干预和本体感觉干预是最有前景的干预措施，在大多数结果中一直是治疗的首选。在临床实践中使用这些干预措施有助于控制帕金森病患者的运动症状和生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.