视觉反馈增加帕金森病患者的呼气肌训练努力：一项随机交叉试验
Visual feedback increases expiratory muscle training effort in Parkinson's disease: a randomised crossover trial.
文献信息
| PMID | 42881452 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Martin Srp |
| 作者单位 | Department of Neurology, Centre of Clinical Neuroscience, First Faculty of Medicine, General University Hospital, Charles University, Katerinska 30, Prague 2, 128 21, Prague, Czech Republic. |
| 期刊 | Journal of neuroengineering and rehabilitation |
| SCI 分区 | Q1 |
| IF | 6.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 气道保护障碍，包括咳嗽和吞咽受损，是帕金森病临床上重要的并发症。呼气肌力量训练（EMST）是针对这些缺陷的既定非药物干预。本研究旨在评估SpiroGym移动健康应用程序提供的视觉反馈对帕金森病患者EMST期间呼气肌激活的急性效应。
方法： 我们在帕金森病患者中开展了一项单中心、随机、两周期交叉试验。参与者按随机顺序在两种条件下进行EMST：无视觉反馈的传统EMST和有SpiroGym应用程序提供实时视觉反馈的EMST。呼气肌激活通过腹肌表面肌电图测量。主要结局是两种条件下平均峰值归一化腹内斜肌活动的参与者内差异。次要结局包括腹外斜肌和腹直肌活动、与神经精神症状的关联以及参与者报告可用性评分。
结果： 20名参与者被随机分组，19名完成研究并纳入最终分析。未发生与研究相关的不良事件。与无反馈相比，视觉反馈显著增加平均峰值归一化腹内斜肌活动（118.2 ± 36.4% vs. 90.5 ± 23.0% 参考自主收缩；p < 0.001；Cohen d = 0.95）。无反馈时，腹内斜肌激活从第一组的100.1 ± 22.2%显著下降至第五组的84.4 ± 25.5%，而有反馈时保持稳定（120.3 ± 29.4% 至 119.9 ± 40.6%）。有反馈时腹外斜肌激活也显著更高（122.2 ± 38.1% vs. 100.9 ± 32.4%；p = 0.002；Cohen d = 0.66），而腹直肌激活在两种条件间无显著差异（105.2 ± 41.3% vs. 90.2 ± 36.1%；p = 0.06；Cohen d = 0.43）。未检测到反馈反应性与抑郁、淡漠或焦虑之间的显著关联。参与者将视觉反馈评为易于理解且有助于EMST表现。
结论： SpiroGym应用程序提供的实时视觉反馈在帕金森病患者EMST期间急性增加并稳定了呼气肌激活。试验注册 ClinicalTrials.gov NCT06942533，2025年5月1日。
英文摘要
BACKGROUND: Disorders of airway protection, including impaired cough and swallowing, are clinically important complications of Parkinson's disease. Expiratory muscle strength training (EMST) is an established non-pharmacological intervention targeting these deficits. The aim of this study was to evaluate the acute effect of visual feedback provided by the SpiroGym mHealth app on expiratory muscle activation during EMST in people with Parkinson's disease.
METHODS: We conducted a single-center, randomised, two-period crossover trial in people with Parkinson's disease. Participants performed EMST under two conditions, in randomised order: conventional EMST without visual feedback and EMST with real-time visual feedback provided by the SpiroGym app. Expiratory muscle activation was measured using surface electromyography of the abdominal muscles. The primary outcome was the within-participant difference in mean peak normalised internal oblique activity between conditions. Secondary outcomes included external oblique and rectus abdominis activity, associations with neuropsychiatric symptoms, and participant-reported usability ratings.
RESULTS: Twenty participants were randomised, and 19 completed the study and were included in the final analysis. No study-related adverse events occurred. Visual feedback significantly increased mean peak normalised internal oblique activity compared with no feedback (118.2 ± 36.4% vs. 90.5 ± 23.0% of reference voluntary contraction; p < 0.001; Cohen d = 0.95). Without feedback, internal oblique activation significantly declined from 100.1 ± 22.2% in the first set to 84.4 ± 25.5% in the fifth set, whereas it remained stable with feedback (120.3 ± 29.4% to 119.9 ± 40.6%). External oblique activation was also significantly higher with feedback (122.2 ± 38.1% vs. 100.9 ± 32.4%; p = 0.002; Cohen d = 0.66), while rectus abdominis activation did not differ significantly between conditions (105.2 ± 41.3% vs. 90.2 ± 36.1%; p = 0.06; Cohen d = 0.43). No significant associations between feedback responsiveness and depression, apathy, or anxiety were detected. Participants rated the visual feedback as easy to understand and helpful for EMST performance.
CONCLUSIONS: Real-time visual feedback delivered by the SpiroGym app acutely increased and stabilized expiratory muscle activation during EMST in people with Parkinson's disease. Trial registration ClinicalTrials.gov NCT06942533, 1 May 2025.