Vanhu vane-kutanga kusvika pakati pepakati vanogona kuita zvekuita zvekuita masimba pane chetsika
Zvakajeka kuti kurovedza muviri kunobatsira vanhu vane chirwere chePasinson chekutanga uye chepakati-kati. Chisinganyatsonzwisisi ndechipi rudzi rwekuita muviri kunobatsira vanhu vane chirwere ichi. Hazvisi pachenawo kuti simba rekuita basa rinobatsira sei.
Munguva pfupi yapfuura, vatsvakurudzi vakafarira zvikuru kurovedza muviri sekurapa kwePalinson's disease. Nenzira, chirwere chePasinson chave chichirapwa uchishandisa mishonga uye kuvhiyiwa; zvisinei, kurovedza muviri kunopindira, kusingatauri kupindira nemashoma emigumisiro kunze kwezvishoma zvinyorwa uye marwadzo.
Uyezve, kushandiswa kwezvinodhaka zvinoshandiswa kurapa zvirwere zveParkinson zvinoderera nekufamba kwemazuva, uye zvirwere-kuchinja kusina-pharmacologic zvigadziro zvinonyanya kudiwa kurwisa chirwere chacho.
Tisati tatarisa zvidzidzo zvishomanana kuongorora zviratidzo zvePalinson's disease, zvakakosha kutsanangura imwe pfungwa. Zvinogona kuoneka sechinhu chisinganzwisisiki kune munhu ane chirwere cheChinsinson kuti aite zvakanyanya-kupindira maitiro paatreadmill. Mushure mezvose, chirwere chePasinson chinokonzerwa neurodegenerative iyo inoguma nekugadzikana, kudengenyeka, kutadza kusagadzikana, nezvakadaro. Asi ramba uchifunga kuti varwere vari mune zvidzidzo izvi vakange vasati vari pamwe chete mumatambudziko avo. Mune mamwe mazwi, kukwirira-kuwedzeresa muviri hakuna kuongororwa pavanhu vane chirwere chePasinson chekupedzisira.
Zvirwere zvePacinsinson: Background Info
Chirwere chePasinsinson chinowanzowanzoitika zvisingatauri uye hachizivikanwe zvakabva. Vanenge mamiriyoni maviri vokuAmerica vanogara nehosha yaPasinson.
Munyika yose mune vanhu vane mamiriyoni gumi vanogara nechirwere chePasinson. Mavhareji emakore ekuongororwa kweavo vane chirwere chePasinson makore makumi matanhatu, uye chirwere ichi chinowedzera zvishoma nezvishoma mumakore gumi nemashanu anotevera mushure mekuongorora.
Muchiropi, masero emagunha anoshandisa dopamine kudzivirira kufamba kwemaviri. Muvanhu vane chirwere chePasinson, masero europi anoita dopamine zvishoma nezvishoma anofa.
Nokufamba kwenguva, zvinova zvakaoma kune vanhu vane chirwere chePasinson kuti vatame matumbo avo.
Izvi zvinotevera zviratidzo zvePalinson's disease:
- "Kufuridza-kupfurikidza" kudengenyeka kwemaoko pazororo
- "Cogwheel" yakasimba
- Slow muscle movements (kureva, bradykinesia)
- Drooling
- Shuffling gait
- Kufunganya
- Monotone izwi
- "Kusvibiswa" kutarisa chiso
- Stooped posture
- Constipation
- Kuziva kusagadzikana
- Kurara kuvhiringidzika
- Kusagadzikana
Kuonekwa kwechipatara chePasinsinoni kunobva munhoroondo uye kuongorora kwepanyama kunowanikwa. Zvakakosha, neuroimaging, EEG, uye zvidzidzo zvepelinha zvinowanzova mumiganhu yakakwana yezera kune avo vane chirwere chaPasinson.
Zvinosuruvarisa, hapana mushonga wePalinson's disease. Zvimwe zvinodhaka zvakadai se carbidopa-levodopa (Sinemet) uye MAO-B inhibitor zvinogona kushandiswa kuchinja kana kuwedzera dopamine mazinga muuropi. Izvi zvinodhaka zvinonzi dopaminergic, zvisinei, zvinorasikirwa nekubudirira kwekufamba kwenguva uye zvine migumisiro yakaipa.
Chirwere chePalinson chinotarisirwawo zviratidzo nemishonga inobatsira nekuvhiringidzika kwepfungwa, kunetseka kwepfungwa, uye zvinetso zvekurara.
Ichochose-uropi hunokurudzira rudzi rwekuvhiya hunoshandiswa kurapa chirwere chePalinson. Iyi nzira inogona kubatsira nekudzivirira zviratidzo zvehutano, zvakadai sokudengenyeka, kusagadzikana, kuoma, uye zvinetso nekufamba.
Muna 2001, migumisiro kubva kuChrisrane Review yakaratidza kuti pakanga pasina uchapupu hwakakwana hwekutsigira kana kutsigira kubatsirwa kwedzidzo ipi zvayo mukurapa chirwere chePasinson. Uyezve, panguva iyoyo, mukugadzirisa kwekuedza, migumisiro yekuita zvepabonde paPalinson's disease yaiva nguva pfupi, pasina nguva yakareba yekutevera. Kunyange zvakadaro, kwemakore zvakambofungidzirwa kuti kuenderera mberi kwekurovedza muviri kune avo vane chirwere chePasinson chakanga chiri kudiwa kuti zvishoma nezvishoma zvirambe zvichisimba, kushanduka, uye kuenzanisa.
Kutsungirira kunoitwa kwakaratidzwa kukurudzira kukura uye kukura kwemitsipa uye kuchengetedza masero emagetsi mumhando dzemhuka.
Zvisinei, mhando dzemhuka hadzisi dzakafanana nevanhu.
Pakupedzisira, tsvakurudzo dzakawanda dzekudzorera dzakaratidza kuti kuenzanisa kwekuita nesimba mukati mekupera kweupenyu hunogona kuchengetedza chirwere chaPasinson muupenyu hwekupedzisira.
Kubvuma Kwenguva refu Kuita Kudzidzira
MunaNovember 2012, Schenkman uye vashandi vake vakaongorora zvishoma uye kwenguva refu zvigaro zvemarudzi maviri akasiyana-siyana ekurovedza muviri muvadzidzi vanenge vachidzidza nePalinson's disease. Izvo zvinongororwa zvinotungamirirwa zvekuvhiya zvinopindira mhosva zvakaitika mukati memwedzi gumi nematanhatu uye zvakaitwa mumakiriniki ekurapa.
Muchidzidzo chacho, 121 vatori vechikamu vane chirwere chepachivande chePacinson chakatangira-kana pakati pepakati vakagoverwa kune rimwe remapoka matatu. Boka rokutanga rakabatanidzwa mukugadzirisa / kuenzanisa / kushanda maitiro. Boka rechipiri rakaita basa rekushandisa aerobic uchishanda nekamba, bhasikoro, kana elliptical mudzidzisi. Chechitatu, kana kuti boka rinodzora, rinodzidziswa pamba-sezvinorondedzerwa mune chirongwa chemafaro chinonzi Fitness Counts , chakagadzirwa neNational Parkinson Foundation.
Mapoka maviri ekutanga akataridzirwa paairatidza katatu pavhiki kwemwedzi mina. Shure kwaizvozvo, kutarisirwa kwaiitwa kamwechete pamwedzi kwehuwandu hwemwedzi gumi nemwedzi uchidzidza. Boka rekutonga rakarongedzwa kamwe chete pamwedzi kwemwedzi gumi nematanhatu.
Vaparidzi vakaongororwa vachishandisa miedzo yakasiyana-siyana pa4, 10, uye 16 mwedzi. Heino vatsvakurudzi 'vakawana:
- Kwemwedzi mina, gwaro rose rakashandurwa mumamiriro ekugadzirisa / kuenzanisa / boka rekuenzanisa neiyo yeaerobic maitiro uye mapoka ekudzivirira.
- Pana 4, 10, uye 16 mwedzi, kufamba kwehupfumi (kureva, kushanda zvakanaka) kunovandudzika muboka rekuita zvemaitiro kana richienzaniswa neyekushandura / kuenzanisa / boka rebasa.
- Kuenzanisa kwaive kwakafanana pakati pemapoka ose.
- Mwedzi 4 ne16, mabasa ehupenyu hwezuva nezuva akavandudzwa muhutano hwakanaka / kuenzanisa / boka revanhu kana zvichienzaniswa neyeboka rekutonga.
Migumisiro yenyaya ino inoratidza kuti maitiro akasiyana-siyana ezvidzidzo anopa zvakasiyana zvakasiyana kune avo vane chirwere chePasinson. Mipurogiramu yekutsungirira inoratidzika seyo inobatsira zvakakosha kwenguva refu.
Maererano naSchenkman uye vanyori vanyori:
Makomborero ekuremekedza kubva kuvadzidzi vekudzidza kwemwedzi gumi nemasere anosimbisa kuti vanhu vanoda rubatsiro runoramba rwuripo kuti varambe vachirovedza muviri. Tinonyatsokurudzira kuti makiriniki anowana nzira dzekubatsira vanhu vane PD [Parkinson's disease] kukudziridza nekuchengetedza maitiro ekuita muviri kwenguva yakareba, kusanganisira zvirongwa zvekushandisa zvakakodzera pamwe nekuenderera mberi kuongorora nekusigirwa.
Nenzira, chidzidzo ichi chaiva nekukwanisa kwayo.
Kutanga, boka rekutonga rakabatanidzwa mune rimwe basa nokuti zvingava zvisina kunaka kuti vatori vechikamu ava vasagamuchira chero basa chero ripi zvaro. Mune mamwe mazwi, kunyange zvazvo "chechokwadi" boka revanhu rinenge risingaiti maitiro mukati memwedzi gumi nematanhatu, kurumbidza kuti sarudzo iyi ingakanganisa utano. Maererano nevanotsvakurudza, huwandu hweFitness Counts hutungamiri hwakabudiswa neNational Parkinson Foundation hwakaguma kune humwe rubatsiro, asi kwete ruzivo rwakawanda sezvakawanikwa nevatori vechikamu mumapurogiramu ezvipatimendi anotarisirwa zvinosanganisira kushandura mafungiro / kuenzanisa / kushanda mabasa kana maitiro aerobic.
Chechipiri, chidzidzo ichi chakaitwa muColorado, icho chiri chimwe chezvinyorwa zvakanyanya muUnited States. Zvichida kuti vatori vechikamu muchidzidzo ichi vanoita zvakawanda pane zvinyorwa kupfuura vamwe vanhu mune mamwe maitiro saka vanoita zvigumisiro zvishoma zvisingakwanisi.
Chechitatu, vatori vechikamu mune rimwe nerimwe mapoka matatu vakagamuchira zviyero zvakasiyana zvekutariswa kwega, izvo zvinogona kuvhiringidza mhinduro.
Pakupedzisira, zvaive zvakaoma kuongorora kubatisisa kudzidzira maitiro, uye vatsvakurudzi vakatenderera pamatanda emabasa-kwete mabasa ekuongorora-kuita zvisarudzo zvakadaro.
Kuwedzera-Kuwedzera Kuita Kudzidzira uye Matambudziko aPasinson
Chidzidzo muPasinsinson Matambudziko Ekuita Kudzidzira (SPARX) yaiva chikamu chechipiri, chirongwa chekliniki chisingarambi chakaitwa naSchenkman uye vashandi pakati paMay 2012 naNovember 2015. Vagari vemutambo vakaongororwa mushure memwedzi mitanhatu.
MuSARAR trial, vatori vechikamu 128 vane chirwere chePasinson avo vaiva nemakore pakati pemakore makumi mana nemakumi mapfumbamwe nemakumi mapfumbamwe vakapatsanurwa kuva mapoka matatu.
Bhuku rekutanga rekuongorora rakaitwa nepamusoro-shanduko yekuita basa, rechipiri boka rekuedza rakaitwa nekuenzanisa kwemaitiro, uye nhengo dzeboka rekutonga dzakanga dzakatarirwa kushandiswa kwemaitiro emangwana. (Zvakare, zvingava zvisina kukodzera kuramba boka rinodzora mukana wekushandisa.)
Nemaziso, avo vatora muongororo vakaongororwa vane chirwere cha de novo Parkinson (kureva, vakaonekwa mukati memakore mashanu apfuura) uye vakanga vasina kutarisirwa kuti vawane mishonga inonzi dopaminergic (antiparkinson) munguva yemwedzi mitanhatu yekuita kwavo. Uyezve, hapana mumwe wevatori vechikamu aimbove akabatanidzwa mukuenzanisa-kana kukwirira-simba.
Kunyanya-kusimba maitiro kwakave nemazuva mana pavhiki pane zvinyorwa zvepamusoro pamapfumbamwe kubva kuzana kusvika ku85 muzana zvakanyanya kukura kwemoyo. Kuenzanisa-kwakasimba kwekuita muviri kwakaitikawo kanomwe pavhiki asi pakati pe 60% uye 65 muzana zvakanyanya kuwanda kwemwoyo.
Chinangwa chegadziriro 2 SPARX kuedza kuongorora kana varwere vane chirwere chePasinson vaigona kushanda zvakasimba mukukwirira kwekudzidzira. Vatsvakurudzi havana kugona kana kushandisa pakati pe80 kubva muzana uye 85 muzana yepfungwa yemoyo yakakura zvakaguma kwakaguma mukurapa kunobatsira kune avo vane de novo Parkinson chirwere. Pakupedzisira, vatsvakurudzi vaifarira kugadzirisa kana kukura kwemasimba kunogona kuongororwa muchikamu chechitatu maedzo. Iyi nhanho yechitatu inenge ichizoongorora zvinobvira zvinobatsira zvekupindira uku.
Maererano naSchenkman uye vanyori vanyori:
Chimwe chezvipingamupinyi zvinokonzera kutamira muchikamu chechitatu miedzo ndechokuti chirongwa chakakodzera chekurovedza muviri hachisati chagadziriswa chero chipi zvacho chekuita basa. Kuita zvekuita kunokonzera kubatanidzwa kukuru kwekuita kwemaawa nekuedza nekuenzaniswa nemishandisirwo emishonga. Izvo zvakasikwa zvisina kusimbisa zvakashandiswa kunyatsojekesa kana kuongorora kwakanyanya kwemazivo ekuita basa kwakarongeka, kuratidza nzira yekugadzirisa zvakakwana chirongwa chakakodzera musati matamira mberi muchikamu chekutanga chekuongorora maitiro muParkinson chirwere. Kuwanikwa kwekusagutsikana kwekukwirira kwepamusoro-soro kunofanirwa kuita kuti munda uende mberi zvikuru.
Shanduro yeSPARX yakanga ine zvishoma.
Kutanga, kukwirira-simba kwekudzidzira kwakagadzirwa chete pazvinyorwa zvekutsika uye kusashandisa mamwe maitiro ekugadzira zvinhu.
Chechipiri, zvose zvakagadziriswa nekufambisa uye kushanda zvakagadziriswa kuti zvive nehupamhi hwekudzidzira; zvisinei, hazvisi pachena kana zvimwe kana zvose zviri zviviri izvi zvinogona kuvandudza motokari zviratidzo muhosha yaPasinson.
Chechitatu, hazvina kunyatsojeka kuti kubatanidza kuwedzerwa kwepamusoro-soro chekuita basa nekumwe kupindira kwepirotheotherapy nemubatsiro unozivikanwa kune avo vane chirwere chaPasinson, chakadai sa Tai Chi kana kudzidziswa simba, zvinogona kuita kuti zvikwereti zvakanyanya zvakabatsire.
Shoko Rinobva
Tinoziva kuti kurovedza muviri kunobatsira vanhu vane chirwere chePasinson. Kutsvakurudza kutsva kunoratidza kuti kuwedzerwa kwepamusoro-soro kunogona kupiwa zvakachengeteka kune varwere vane chirwere cheParkinson chakanaka uye kuti vanhu vane chirwere chepachivande chePacinson vanobatsirwa nemhando dzakasiyana-siyana dzekudzidzira, kusanganisira kuchinja, kuenzanisa, uye aerobic.
Kutsvakurudza kwakawanda kunofanirwa kuitwa kuti uwane zvakanakira zvikwereti zvakadaro zvakasimba. Kana iwe kana munhu waunoda akaonekwa kuti ane chirwere chePasinson, tapota taura nachiremba wako pamusoro pemhando ipi yekurovedza muviri yakakunakira iwe.
> Sources:
> Dambudziko rePasinson. Muna: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. Harrison's Manual of Medicine, 19e New York, NY: McGraw-Hill.
> Dambudziko rePasinson. Medline Plus. https://medlineplus.gov/parkinsonsdisease.html.
> Schenkman M, et al. Migumisiro yeHigh-Intensity Treadmill Kudzidzira Mavhinga Zviratidzo Muvarwere Ne Devo Parkinson Zvirwere A Phase 2 Randomized Clinical Trial. JAMA Neurology. December 11, 2017. ini: 10.1001 / jamaneurol.2017.3517.
> Schenkman M, et al. Dzidzira Vanhu Mukutanga-Kana Mukati-Stage Parkinson Zvirwere: Mwedzi 16-Mwedzi Randomized Controled Trial. Therapy Therapy. 2012; 92 (11): 1395-1410. doi: 10.2522 / ptj.20110472.