中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (10): 2560-2568.doi: 10.12307/2026.647

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

水中运动干预老年帕金森病患者平衡功能与运动能力的Meta分析

李婷文1，2，张建华3   

  1. 1闽南师范大学体育学院，福建省漳州市  363000；2湖北休闲体育发展研究中心，湖北省武汉市  430062；3西北师范大学体育学院，甘肃省兰州市  730070
  • 收稿日期:2025-06-06 接受日期:2025-06-28 出版日期:2026-04-08 发布日期:2025-08-30
  • 通讯作者: 张建华，教授，博士研究生导师，甘肃省第一层次领军人才，西北师范大学体育学院，甘肃省兰州市 730070
  • 作者简介:李婷文，女，1989年生，博士，讲师，硕士研究生导师，主要从事运动技术诊断与评估方面的研究。
  • 基金资助:
    国家社科基金项目(20BTY090)，项目负责人：张建华；教育部人文社会科学研究基金项目(24YJCZH145)，项目负责人：李婷文；福建省社会科学研究基金项目(FJ2022C014)，项目负责人：李婷文；湖北休闲体育发展研究中心开放基金项目(2022A008)，项目负责人：李婷文

Meta-analysis of the effects of aquatic exercise on balance function and motor ability in elderly patients with Parkinson’s disease

Li Tingwen1, 2, Zhang Jianhua3   

  1. 1School of Physical Education, Minnan Normal University, Zhangzhou 363000, Fujian Province, China; 2Hubei Leisure Sports Development Research Center, Wuhan 430062, Hubei Province, China; 3School of Physical Education, Northwest Normal University, Lanzhou 730070, Gansu Province, China
  • Received:2025-06-06 Accepted:2025-06-28 Online:2026-04-08 Published:2025-08-30
  • Contact: Zhang Jianhua, Professor, Doctoral supervisor, School of Physical Education, Northwest Normal University, Lanzhou 730070, Gansu Province, China; Hubei Leisure Sports Development Research Center, Wuhan 430062, Hubei Province, China
  • About author:Li Tingwen, PhD, Lecturer, Master’s supervisor, School of Physical Education, Minnan Normal University, Zhangzhou 363000, Fujian Province, China; Hubei Leisure Sports Development Research Center, Wuhan 430062, Hubei Province, China
  • Supported by:
    National Social Science Foundation of China, No. 20BTY090 (to ZJH); Humanities and Social Sciences Research Fund, Ministry of Education, No. 24YJCZH145 (to LTW); Fujian Provincial Social Science Research Fund, No. FJ2022C014 (to LTW); Hubei Leisure Sports Development Research Center Fund, No. 2022A008 (to LTW)

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摘要：


文题释义：
水中运动：指在30-35 ℃恒温水环境中开展的、以改善神经肌肉控制为目标的结构化身体活动，包含浮力辅助平衡训练(水中太极)、阻力步态训练(水下跑步机训练)及核心肌群激活练习(水中抗阻球操)三大类。干预周期为4-11周，单次训练时长45-60 min，运动强度通过Borg量表监控且维持在12-14级。水中运动的核心机制是通过水的流体阻力提供渐进式抗阻刺激，促进帕金森病患者下肢肌力增长，进而降低跌倒恐惧心理，延长单腿站立时间。
帕金森病：此研究聚焦于符合《中国帕金森病治疗指南(第三版)》诊断标准，Hoehn-Yahr分期1-3级的原发性帕金森患者，其核心运动症状包括运动迟缓(帕金森病评价量表第三部分评分基线≥18分)、静止性震颤(振幅≥2 cm)及姿势反射障碍(后拉试验阳性率100%)。区别于广义帕金森患者群体，此研究排除合并严重认知障碍(简易智力状态检查量表< 24分)及直立性低血压(收缩压下降≥20 mmHg)患者，确保水疗安全性。

目的：系统评价水中运动对老年帕金森病患者平衡功能与运动能力的影响。
方法：检索中国知网、万方与维普等中文数据库，以及Web of Science、PubMed、EMBASE、ScienceDirect、Cochrane Library等英文数据库，筛选出水中运动干预老年帕金森病患者的随机对照试验研究文献。检索时限从 2000年1月至2025年3月，研究组采用水中运动或水陆联合运动方式，对照组采用常规康复或陆地运动方式。结局指标包括帕金森量表第三部分评分、Berg平衡量表评分、起立-行走计时测验、帕金森病调查问卷39评分及5 min起坐测试结果。由2名研究者独立提取数据，并按照 Cochrane手册5.3标准对纳入文献进行偏倚风险评估，采用RevMan 5.3统计软件进行Meta分析。
结果：此次Meta分析共纳入7篇随机对照试验研究，共计241例患者。分析结果显示，与对照组相比，研究组干预后Berg平衡量表评分(MD=5.30，95%CI：2.55-8.06，P=0.000 2)、5 min起坐测试次数(MD=3.79，95%CI：1.84-5.75，P=0.000 1)明显升高，起立-行走计时明显缩短(MD=-1.93，95%CI：-2.64至-1.22，P < 0.000 01)。两组干预后帕金森评价量表第三部分评分(MD=-1.31，95%CI：-3.90-1.28，P=0.32)、帕金森病调查问卷39评分(MD=-3.64，95%CI：-9.77-2.49，P=0.24)均无统计学差异。
结论：水中运动显著改善了老年帕金森病患者的平衡功能、下肢肌力、步态速度及移动能力，但对上肢协调性、精细动作等运动能力及生活质量的改善效果尚不明确，未来仍需通过方法严谨、长干预周期的研究进行验证。
https://orcid.org/0009-0004-1196-9674(李婷文)

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 水中运动, 帕金森病, 平衡功能, 运动能力, 下肢肌力

Abstract: OBJECTIVE: To systematically evaluate the effects of aquatic exercise on balance function and motor ability in elderly patients with Parkinson’s disease.
METHODS: A comprehensive search for randomized controlled trial studies of aquatic exercise interventions for elderly patients with Parkinson’s disease was conducted in Chinese databases such as CNKI, WanFang, and VIP, as well as English databases including Web of Science, PubMed, EMBASE, ScienceDirect, and the Cochrane Library. The search period ranged from January 2000 to March 2024. The intervention group received aquatic exercise or combined aquatic and terrestrial exercise modalities, while the control group engaged in routine rehabilitation or land-based exercises. Outcome measures included the score of Part III of the Unified Parkinson’s Disease Rating Scale, the Berg Balance Scale score, the Timed Up and Go test, the Parkinson’s Disease Questionnaire-39 score, and the results of the 5-Minute Sit-to-Stand test. Two researchers independently extracted the data and assessed the risk of bias for each included study according to the Cochrane Handbook 5.3 criteria. Meta-analysis was performed using RevMan 5.3 statistical software.
RESULTS: A total of 7 high-quality randomized controlled trials, involving 241 patients, were included in this meta-analysis. The results indicated that, compared with the control group, the intervention group showed significantly higher scores on the Berg Balance Scale [mean difference (MD)=5.30, 95% confidence interval (CI): 2.55-8.06, P=0.000 2] and the 5-Minute Sit-to-Stand test [MD=3.79, 95% CI: 1.84-5.75, P=0.0001] after the intervention. Additionally, the Timed Up and Go test time was significantly shorter in the intervention group [MD=-1.93, 95% CI: -2.64 to -1.22, P < 0.000 01]. However, there were no statistically significant differences between the two groups in the Part III of the Unified Parkinson’s Disease Rating Scale scores [MD=-1.31, 95% CI: -3.90-1.28, P=0.32] or the Parkinson’s Disease Questionnaire-39 scores [MD=-3.64, 95% CI: -9.77-2.49, P=0.24] after the intervention. 
CONCLUSION: Aquatic exercise significantly improves balance function, lower limb muscle strength, gait speed, and mobility in elderly patients with Parkinson’s disease. However, its effects on overall motor functions such as upper limb coordination and fine motor skills, as well as on quality of life, remain unclear. Further studies with rigorous methodologies and longer intervention periods are warranted to validate these findings.

Key words: aquatic exercise, Parkinson’s disease, balance function, motor ability, lower limb muscle strength

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