Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector107410.17816/ACEN.1074ReviewsОбзорыReview ArticleAerobic Exercise in Rehabilitation of Patients with Parkinson’s DiseaseАэробная физическая нагрузка в реабилитации пациентов с болезнью Паркинсонаhttps://orcid.org/0000-0001-8659-9832GusevaOlga V.ГусеваОльга Владимировна
Russian Federation

Cand. Sci. (Med.), exercises treatment doctor, Physiotherapy department, assistant professor, Division of advanced-level therapy with a course in rehabilitation, physiotherapy and sports medicine

канд. мед. наук, врач по лечебной физкультуре отделения физиотерапии, доцент каф. госпитальной терапии с курсом реабилитации, физиотерапии и спортивной медицины

gusolvl@gmail.comSiberian State Medical UniversityСибирский государственный медицинский университет0612202418476821912202303042024Copyright ©; 2024, Guseva O.V.Copyright ©; 2024, Гусева О.В.2024Guseva O.V.Гусева О.В.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/1074

Disability due to Parkinson’s disease (PD) is increasing faster than for any other neurodegenerative disorder. A multidisciplinary approach to rehabilitation of patients with PD is recommended including various types of physical training. Because of its general beneficial effect, aerobic endurance training is necessary for all people to maintain their health. Aerobic exercise in PD is also used for rehabilitation of motor and non-motor symptoms. This article justifies the choice of aerobic exercise intensity, shows challenges in selecting intensity based on maximum oxygen consumption due to the influence of clinical and behavioral factors, difficulties in assessing the effectiveness of therapy due to the wide range of training intensity and amount in the studies. The article summarizes types of exercises used in rehabilitation of patients with PD (walking, Nordic walking, training with a bicycle ergometer and treadmill, aquatic exercises) and their benefits for patients with different courses of the disease. For patients with freezing of gait, bicycle ergometer is a piece of equipment of choice for aerobic stationary training, and Nordic walking is a preferred type of outdoor training. The author shows the role of aerobic training in the treatment of non-motor symptoms such as depression, cognitive changes, and sleep disorders. A question about the use of aerobic training in patients with Hoehn–Yahr grade 4–5 of PD remains open. Further studies are needed to evaluate training protocols, assess rehabilitation effectiveness and evaluate physical training in the advanced PD.

Болезнь Паркинсона (БП) является заболеванием с самым высоким приростом инвалидности среди нейродегенеративной патологии. Рекомендован мультидисциплинарный подход к реабилитации пациентов с БП, включающий различные типы физических тренировок. Аэробная тренировка на выносливость, вследствие общеукрепляющего действия, необходима для поддержания здоровья всем людям. Аэробную нагрузку при БП применяют также для реабилитации моторных и немоторных симптомов. В статье обоснован выбор интенсивности аэробной нагрузки, показаны трудности в подборе интенсивности при определении максимального потребления кислорода из-за влияния клинических и поведенческих факторов пациентов, сложности оценки эффективности терапии вследствие широкого диапазона представленных в исследованиях показателей интенсивности и объёма нагрузки. В статье обобщены типы спортивно-прикладных упражнений на выносливость, встречающихся при реабилитации пациентов с БП (ходьба, скандинавская ходьба, тренировки на велоэргометре и тредмиле, упражнения в воде), и их преимущества при разном течении болезни. Например, для пациента с застыванием аппаратурой выбора для аэробной стационарной тренировки является велоэргометр, а тренировки на улице предпочтительны в виде скандинавской ходьбы. Автором показано значение аэробной нагрузки для терапии немоторных симптомов: депрессии, когнитивных изменений и нарушения сна. Открытым остаётся вопрос о применении аэробной нагрузки у пациентов с БП 4–5-й стадии по Hoehn–Yahr. Требуются дальнейшие исследования по протоколу нагрузки, оценке эффективности реабилитации и применению нагрузки на развёрнутой стадии БП.

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