Systematic review and meta-analysis of overall effect of different exercise interventions on gait and balance parameters in people with Parkinson\u27s disease

Parkinsonova bolezen med drugim vpliva na slabšanje hoje in ravnotežja, saj progresija Parkinsonove bolezni povzroča krajšanje korakov, upočasnitev hitrosti hoje ter pogostejše padce. Raziskave so pokazale, da redna vadba pri osebah s PB vpliva na izboljšanje ravnotežja, kakovost izvajanja vsakodnevnih aktivnosti, dolžino koraka ter samo hitrost hoje. Namen dela je bil ugotoviti in raziskati učinek različnih tipov vadb na izbrane parametre hoje in ravnotežja pri osebah s Parkinsonovo boleznijo ter ugotoviti, kateri tip vadbe povzroči največjo razliko med eksperimentalno in kontrolno skupino v hitrosti hoje in dolžini dvokoraka. Na podlagi rezultatov sistematičnega pregleda literature in metaanalize smo nato oblikovali smernice in priporočila za vadbo z osebami s Parkinsonovo boleznijo. Sistematični pregled literature smo naredili v Google Scholar in Pubmed podatkovni bazi. V analizo smo na podlagi vključitvenih in izključitvenih kriterijev na koncu vključili 23 raziskav. Analizirali smo velikost učinka ter vpliv specifične vadbe za razvoj RK, nespecifične vadbe za razvoj RK, VM in vadbe z zunanjo povratno informacijo na hitrost hoje, dolžino dvokoraka, Bergovo lestvico ravnotežja in test vstani in pojdi. Podatke smo najprej obdelali v Microsoft Excel 2010 in nato statistično analizirali v programu Review Manager 5.4.1. Vsem vključenim raziskavam smo ocenili tveganje za pristranskost. Rezultati kažejo, da gibalna dejavnost izboljša preučevane parametre hoje in ravnotežja. Na posamezen parameter imajo nekatere izbrane gibalne dejavnosti večji vpliv, druge manjši, vendar kombinacija vseh štirih v vseh primerih izboljša rezultat posameznega parametra. Na podlagi rezultatov sistematičnega pregleda in metaanalize so oblikovane smernice in priporočila za vadbo oseb s Parkinsonovo boleznijo.Parkinson\u27s disease highly impacts on person\u27s gait and balance. With disease progression strides and steps are shorter, gait velocity is slowing down and frequency of falls is higher. Studies have shown that regular exercise in people with Parkinson\u27s disease improves balance, step and stride length, gait velocity, quality of life and everyday activities. The purpose of this master\u27s thesis was to research the effect and overall effect of different sistematic exercise interventions on specific gait and balance parameters. Furthermore we wanted to form recommendations and guidelines for exercise in people with Parkinson\u27s disease based on results of systematic review and meta-analysis. Systematic review was made in Google Scholar and Pubmed database. Based on inclusion and exclusion criteria twenty-three studies were included in further analysis. We analysied overall effect of gait and step exercise, balance and coordination exercise, resistance exercise and cues exercise on gait velocity, stride length, Berg\u27s balnce scale and time up and go test. Firtsly data was analysed in Microsoft Excel 2010 and then statistic analyse was made in Review Manager 5.4.1. Additionally risk of bias for each included study was assessed. The results show that exercise intervention improves included parameters of gait and balance. Individual exercise intervention has different effect on each parameter, but combination of all four interventions improves gait and balance. Based on results recommendations and guidelines for exercise are formed for people with Parkinson\u27s disease