Efficacy of neurofunctional versus resistance training in improving gait and quality of life among patients with Parkinson’s disease: a randomized clinical trial

Abstract AIMS to compare the efficacy of neurofunctional training versus resistance training in improving gait and quality of life among patients with PD METHODS This randomized controlled trial included 40 participants randomly assigned to two groups through random number table generator: resistance training (RT) (n=19) and neurofunctional training (NT) (n=21). The RT group performed resistance exercises emphasizing the lower limbs and trunk, while the NT group sessions were focused on gait, functional independence and balance training. Trained physical therapists supervised both groups. The training sessions lasted 60 minutes in each group and were performed twice a week, totalizing 24 sessions. The outcomes, gait and quality of life, were measured using video gait analysis and footprint analysis; and PDQL and PDQ-39 questionnaires, respectively RESULTS intra-group comparison revealed all gait variables (stride length, step length, number of steps, time of distance walked, gait speed and cadence) improved after the NT intervention with large effect size, while only stride length improved in the RT group with moderate effect size. The between group analyses means (Δ) shows that all the variables presented statistically significant differences in the NT group. Additionally, both groups showed significant improvements in quality of life. CONCLUSIONS The application of specific neurofunctional training, directed and enriched with sensorial resources, resulted in superior gait performance among individuals with PD when compared to those in the resistance training group; both treatments were efficacious in improving quality of life.

摘要 目的：比较神经功能训练（neurofunctional training, NT）与抗阻训练（resistance training, RT）对帕金森病（Parkinson's Disease, PD）患者步态及生活质量的改善效果。方法：本随机对照试验（randomized controlled trial）共纳入40名受试者，通过随机数字表法随机分为两组：抗阻训练组（n=19）与神经功能训练组（n=21）。抗阻训练组实施以下肢与躯干为重点的抗阻训练，神经功能训练组则聚焦于步态、功能独立性及平衡训练。两组训练均由经过培训的物理治疗师监督指导。两组每次训练时长均为60分钟，每周训练2次，总计完成24次训练。结局指标方面，步态与生活质量分别通过视频步态分析（video gait analysis）、足迹分析（footprint analysis）以及PDQL、PDQ-39问卷进行评估。结果：组内比较结果显示，神经功能训练组干预后所有步态变量（步幅长度、跨步长度、步数、行走距离耗时、步态速度及步频）均得到显著改善，且效应量较大；而抗阻训练组仅步幅长度得到改善，效应量中等。组间均数差值（Δ）分析显示，神经功能训练组的各项步态变量均存在统计学显著性差异。此外，两组患者的生活质量均得到显著改善。结论：与抗阻训练相比，采用针对性设计且融入感官资源的神经功能训练，可更有效地改善帕金森病患者的步态表现；且两种训练方式均能有效提升患者的生活质量。