Die Effekte des Lee Silverman Voice Treatment (LSVT)-BIG Trainings auf die motorische Funktionsfähigkeit von Menschen mit M. Parkinson – eine systematische Übersichtsarbeit

Zusammenfassung

Hintergrund Interventionen zur Verbesserung der motorischen Funktionsfähigkeit sind wichtige Aspekte der Rehabilitation von Menschen mit Morbus Parkinson. Das Lee Silverman Voice Treatment BIG (LSVT-BIG) ist ein in der klinischen Praxis verbreitetes bewegungstherapeutisches Therapiekonzept bei M. Parkinson, dessen Wirksamkeit auf die motorische Funktionsfähigkeit unklar ist.

Ziel Dieser systematische Review fasst die Studien zur Wirksamkeit des LSVT-BIG auf die motorische Funktionsfähigkeit im Vergleich zu anderen bewegungstherapeutischen Interventionen zusammen.

Methode Die elektronischen Datenbanken MEDLINE, CINAHL und Cochrane Library wurden für den Publikationszeitraum 2005 bis 2017 nach randomisierten kontrollierten Studien (RCT) durchsucht, die das LSVT-BIG bei leicht bis schwer betroffenen Menschen mit idiopathischem M. Parkinson (Hoehn u. Yahr Stadium I–IV) mit anderen bewegungstherapeutischen Interventionen verglichen. Die Bewertung der methodischen Qualität der eingeschlossenen Studien erfolgte anhand der PEDro-Skala. Die eingeschlossenen Studien wurden narrativ zusammengefasst.

Ergebnisse Eingeschlossen wurden 3 RCT mit moderater methodischer Qualität (PEDro-Skala: 5 – 6/10 Punkten). Zwei Studien zeigten keine Vorteile des standardisierten LSVT-BIG-Trainings gegenüber einer anderen bewegungstherapeutischen Intervention bei annähernd vergleichbaren Trainingsdosierungen. In einer Studie, die das LSVT-BIG mit anderen bewegungstherapeutischen Interventionen in anderen Trainingsdosierungen untersuchte, erwies sich das LSVT-BIG als überlegen.

Schlussfolgerungen Aufgrund der geringen Studienzahl ist die Bewertung der Wirksamkeit des LSVT-BIG auf die motorische Funktionsfähigkeit nur bedingt möglich. Für eine mögliche Dose-Response-Beziehung zwischen körperlichem Training – darunter LSVT-BIG – und motorischer Funktionsfähigkeit sind mehr qualitativ hochwertige Studien notwendig.

Abstract

Background Interventions aiming to improve motor functioning are important aspects of the rehabilitation of people with Parkinson’s disease. The Lee Silverman Voice Treatment BIG (LSVT-BIG) is an exercise concept for people with Parkinson’s disease that is commonly applied in clinical care. It’s effectiveness on motor functioning is unclear.

Objective This systematic review summarizes studies on the effectiveness of LSVT-BIG on motor functioning in comparison to other exercise interventions.

Method The electronic data bases MEDLINE, CINAHL and Cochrane Library were consulted for randomized controlled trials (RCT) in the publication period 2005 to 2017 that compared LSVT-BIG for mildly to severly affected people with idiopathic Parkinson’s disease (Hoehn and Yahr stage I–IV) with other exercise interventions.

The methodical quality of the included studies was assessed using the PEDro scale. The included studies were narratively summarized.

Results Three RCT with moderate methodical quality (PEDro scale: 5 – 6/10 points) were included. Two studies showed no advantages of the standardized LSVT-BIG over another exercise intervention with approximately comparable doses of training. One study proved superiority of LSVT-BIG in comparison to other exercise interventions with different doses of training.

Conclusions The appraisal of effectiveness of LSVT-BIG on motor functioning is limited due to the small number of available studies. More studies of high quality are needed to determine a possible dose-response relation between exercise intervention, including LSVT-BIG, and motor functioning.

Schlüsselwörter

Morbus Parkinson - LSVT-BIG - Physiotherapie - Rehabilitation - Review

Key words

Parkinson’s disease - LSVT-BIG - physiotherapy - rehabilitation - review

• Literatur

• 1 De Rijk MC, Launer LJ, Berger K. et al. Prevalence of Parkinson’s disease in Europe: A collaborative study of population-based cohorts. Neurol Diseases in the Elderly Research Group. Neurol 2000; 54: S21-S23
• 2 Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17: 427-442
• 3 Poeck K, Hacke W. Neurologie. Berlin: Springer; 2001
• 4 Schrag A, Jahanshahi M, Quinn N. How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord 2000; 15: 1112-1118
• 5 Keus K, Munneke M, Graziano M. European physiotherapy guideline for Parkinson’s disease. The Netherlands:: KNGF/ParkinsonNet. 2014
• 6 Fahn S, Elton RL. Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Calne D. et al. Recent developments in Parkinson’s disease. Florham Park, NJ: Macmillan Health Care Information; 1987
• 7 Goetz CG, Fahn S, Martinez-Martin P. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Mov Disord 2007; 22: 41-47
• 8 Goetz CG, Tilley BC, Shaftman SR. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Mov Disord 2008; 23: 2129-2170
• 9 Kwakkel G, de Goede CJT, van Wegen EEH. Impact of physical therapy for Parkinson’s disease: a critical review of the literature. Parkinsonism Relat Disord 2007; 13 (Suppl. 03) 87
• 10 Tomlinson CL, Herd CP, Clarke CE. et al. Physiotherapy for Parkinson’s disease: a comparison of techniques. Cochrane Database Syst Rev 2014 CD002815
• 11 Farley BG, Koshland GF. Training BIG to move faster: The application of the speed-amplitude relation as a rehabilitation strategy for people with Parkinson’s disease. Exp Brain Res 2005; 167: 462-467
• 12 Janssens J, Malfroid K, Nyffeler T. et al. Application of LSVT BIG Intervention to Address Gait, Balance, Bed Mobility, and Dexterity in People with Parkinson Disease: A Case Series. Phys Ther 2014; 94: 7
• 13 Millage B, Vesey E, Finkelstein M. et al. Effect on Gait Speed, Balance, Motor Symptom Rating, and Quality of Life in Those with Stage I Parkinson’s Disease Utilizing LSVT BIG(R). Rehab Res Pract 2017; 2017: 9871070
• 14 Ueno T, Sasaki M, Nishijima H. et al. LSVT-BIG Improves UPDRS III Scores at 4 Weeks in Parkinson’s Disease Patients with Wearing-off: A Prospective, Open-Label Study. Parkinson’s Disease 2017; 2017: 1-4
• 15 Ramig LO, Sapir S, Fox C. et al. Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinson’s disease: Ancomparison with untreated patients and normal age-matched controls. Mov Disord 2001; 16: 79-83
• 16 Fox C, Ebersbach G, Ramig L. et al. LSVT LOUD and LSVT BIG: Behavioral Treatment Programs for Speech and Body Movement in Parkinson Disease. Parkinson’s Disease 2012; 2012: 391946
• 17 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
• 18 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 2009; 62: 1006-1012
• 19 Rios LP, Ye C, Thabane L. Association between framing of the research question using the PICOT format and reporting quality of randomized controlled trials. BMC 2010; 10: 11
• 20 Castillo RC, Scharfstein DO, MacKenzie EJ. Observational studies in the era of randomized trials. Finding the balance . J Bone Joint Surg 2012; 94 (Suppl. 01) 112-117
• 21 Maher CG, Sherrington C, Herbert RD. et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83: 713-721
• 22 De Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother 2009; 55: 129-133
• 23 Sherrington C, Herbert RD, Maher CG. et al. PEDro. A database of randomized trials and systematic reviews in physiotherapy.. Man Ther 2000; 5: 223-226
• 24 Dashtipour K, Johnson E, Kani C. et al. Effect of exercise on motor and nonmotor symptoms of Parkinson’s disease. Parkinson’s Disease 2015; 2015: 586378
• 25 Ebersbach G, Grust U, Ebersbach A. et al. Amplitude-oriented exercise in Parkinson’s disease: A randomized study comparing LSVT-BIG and a short training protocol. J Neur Transm 2015; 122: 253-256
• 26 Baer HR, Wolf SL. Modified emory functional ambulation profile: an outcome measure for the rehabilitation of poststroke gait dysfunction. Stroke 2001; 32: 973-979
• 27 Ebersbach G, Ebersbach A, Edler D. et al. Comparing exercise in Parkinson’s disease – the Berlin LSVT(R)BIG study. Mov Disord 2010; 25: 1902-1908
• 28 Aarsland D, Zaccai J, Brayne C. A systematic review of prevalence studies of dementia in Parkinson’s disease. Mov Disord 2005; 20: 1255-1263
• 29 Lieberman A. Depression in Parkinson’s disease -- a review. Acta Neurol Scand 2006; 113: 1-8
• 30 Booth A. Over 85% of included studies in systematic reviews are on MEDLINE. J Clin Epidemiol 2016; 79: 165-166
• 31 Halladay CW, Trikalinos TA, Schmid IT. et al. Using data sources beyond PubMed has a modest impact on the results of systematic reviews of therapeutic interventions. J Clin Epidemiol 2015; 68: 1076-1084
• 32 Michaleff ZA, Costa LOP, Moseley AM. et al. CENTRAL, PEDro, PubMed, and EMBASE are the most comprehensive databases indexing randomized controlled trials of physical therapy interventions. Phys Ther 2011; 91: 190-197
• 33 Seynnes O, Fiatarone SMA, Hue O. et al. Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders. J Gerontol 2004; 59: 503-509
• 34 Steib S, Schoene D, Pfeifer K. Dose-response relationship of resistance training in older adults – A meta-analysis. Med Sci Sports Exerc 2010; 42: 902-914