Abantu abanesisindo sokuqala ukuya emkhathini bangenza umsebenzi wokuzivocavoca ngamandla
Kuyacaca ukuthi ukuvivinya umzimba kusiza abantu abanesifo sePasinson esandulela futhi esesiphakathi. Okungacaci ukuthi yikuphi uhlobo lokuvivinya umzimba olusiza abantu abanalesi sifo. Akucaci nokuthi ukuqina komzimba kusiza kanjani.
Muva nje, abacwaningi baye banesithakazelo esikhulu ekuzivocavoca njengokwelashwa kwesifo sikaParkinson. Ngokwesiko, isifo sikaPasinson siphathwe ngokusebenzisa imithi nokuhlinzwa; Kodwa-ke, ukuvivinya umzimba kungenelela okungekho izindleko, ukungenasidingo kanye nemiphumela emibi embalwa ngaphandle kwezinhlungu nezinhlungu ezincane.
Ngaphezu kwalokho, ukusebenza kwezidakamizwa ezisetshenziselwa ukwelapha isifo sikaParkinson kunciphisa isikhathi esiningi, futhi ukungenelela okungeyona-pharmacologic yokuguqulwa kwezifo kuyadingeka kakhulu ekunqandeni ukugula.
Ngaphambi kokuba sibheke izifundo ezimbalwa ezihlola izifo zesifo sikaParkinson, kubalulekile ukucacisa iphuzu elilodwa. Kungase kubonakale kungenangqondo kumuntu onesifo sikaPasinson ukuba ahlanganyele ekuzivocavoca kakhulu emshinini wokubhala. Phela, isifo sikaPasinson sisimweni esibucayi esibangela ukuqina, ukuthuthumela, ukungazinzi kahle, njalonjalo. Kodwa khumbula ukuthi iziguli kulezi zifundo zase zihamba phambili emgwaqweni wazo wezifo. Ngamanye amazwi, ukuzivocavoca kakhulu akuzange kuvivinywe kubantu abanesifo se-Parkinson esesiphelile.
Izifo ZasePasinson: Ulwazi Lokusendaweni
Isifo sikaParkinson ngokuvamile sivela ngokuzenzekelayo futhi sivela emvelaphi engaziwa. Cishe abantu abayizigidi baseMelika bahlala nesifo sikaParkinson.
Emhlabeni wonke kunezigidi eziyishumi zabantu abahlala nesifo sikaParkinson. Isilinganiso seminyaka yokuxilongwa kwalabo abane-Parkinson's isifo seminyaka engama-60, futhi lesi sifo siqhubeka kancane kancane phakathi neminyaka engu-10 kuya kwengu-25 elandelayo ngemva kokuxilongwa.
Esikhathini sobuchopho, amaseli emisipha asebenzisa i-dopamine ukulawula ukunyakaza kwemisipha. Kubantu abanesifo sikaPasinson, amangqamuzana ebuchopho enza i-dopamine kancane kancane ifa.
Ngokuhamba kwesikhathi, kuba nzima kubantu abanesifo sikaParkinson ukuhambisa imisipha yabo.
Okulandelayo yizinye izimpawu zesifo sikaParkinson:
- Ukuthuthumela kwamaphilisi wezandla ekuphumuleni
- "I-Cogwheel" eqinile
- Ukunyakaza kwemizimba emincane (ie, bradykinesia)
- Kudonsa
- Ukuxhuma
- Ukukhathazeka
- Izwi le-Monotone
- Inkulumo ebusweni "ishicilelwe"
- Ukumiswa okwesikhashana
- Ukuqokwa
- Ukukhubazeka kwengqondo
- Ukuphazamiseka kokulala
- Ukuphumula
Ukuxilongwa kwesifo sikaParkinson kusekelwe emlandweni nasekutholeni ukuhlolwa kokuhlolwa. Okubaluleke kakhulu, ukuhlolwa kwe-neuroimaging, i-EEG, nokufundiswa kwamanzi omgogodla ngokuvamile kuvame ukulinganisa iminyaka yobudala kulabo abane-Parkinson's disease.
Ngeshwa, akekho ukwelashwa kwesifo sikaParkinson. Imithi ethile efana ne-carbidopa-levodopa (Sinemet) ne-MAO-B inhibitors ingasetshenziswa ukufaka esikhundleni noma ukwandisa amazinga e-dopamine ebuchosheni. Lezi zidakamizwa ze-dopaminergic, noma kunjalo, zilahlekelwa yimpumelelo ngokuhamba kwesikhathi futhi zibe nemiphumela emibi emibi.
Isifo sikaParkinson siphathwa ngendlela ephawulekayo nezidakamizwa ezisiza ukuphazamiseka kwemizwelo, izikhalazo zobuhlungu, nezinkinga zokulala.
Ukuvuselela okujulile kobuchopho uhlobo oluthile lokuhlinzwa olusetshenziselwa ukwelapha isifo sikaParkinson. Le nqubo ingasiza ngokukhubaza izimpawu ze-neurological, njengokuthuthumela, ukuqina, ukuqina, nezinkinga zokuhamba.
Ngo-2001, imiphumela evela ku-Review kaCchrane yasikisela ukuthi kwakungekho ubufakazi obanele bokusekela noma ukuphikisa ukuhlomula kwanoma yikuphi ukuvivinya umzimba okwelashwa kwesifo sikaParkinson. Ngaphezu kwalokho, ngaleso sikhathi, ezilungiselelweni zokuhlola, imiphumela yokuzivocavoca ngesifo sikaParkinson yesikhashana, ngaphandle kokulandela isikhathi eside. Noma kunjalo, sekuyiminyaka kucatshangwa ukuthi ukuzivocavoca okuqhubekayo kulabo abanesifo sikaParkinson kwakudingeka ukuba kuphumele ekunciphiseni amandla, ukuguquguquka nokulinganisela.
Imizamo yokukhuthazela iye yaboniswa ukugqugquzela ukukhula nokuthuthukiswa kwezinzwa futhi kuvikelwe amangqamuzana ezinzwa ezithombeni.
Noma kunjalo, izinhlobo zezilwane azifani nabantu.
Okokugcina, ucwaningo oluthile luye lwabonisa ukuthi ukulinganisela ekuzivocavoca ngamandla ngesikhathi seminyaka ephakathi kungavimbela isifo sikaParkinson esikhathini esizayo.
Ukuphendula Kwesikhathi Eside Ukuzivocavoca
NgoNovemba 2012, i-Schenkman kanye nozakwethu bahlola izinzuzo ezincane nezinesikhathi eside zezinhlobo ezimbili ezahlukene zokuzivocavoca kwabahlanganyeli besifundo nesifo sikaParkinson. Icala lokulawulwa kokuzivocavoca ngokungahleliwe lenzeke phakathi nenkathi yezinyanga ezingu-16 futhi kwenziwa emitholampilo yeziguli.
Esicwaningweni, abahlanganyeli abangu-121 abanesifo sokuqala sika-Parkinson noma besigaba esiphakathi babelwa omunye wamaqembu amathathu. Iqembu lokuqala lenza izinto eziguquguqukayo / ukulinganisela / ukusebenza. Iqembu lesibili lisebenza ngokuzivocavoca kwe-aerobic usebenzisa isitifiketi se-treadmill, ibhayisikili, noma umqeqeshi we-elliptical. Iqembu lesithathu, noma elawulayo, lisetshenziswe ekhaya-njengoba lichazwe ohlelweni lokuzivocavoca olubizwa ngokuthi i- Fitness Counts , olwakhiwa yi-National Parkinson Foundation.
Amaqembu amabili okuqala aqondiswa ngenkathi esebenzisa kathathu ngesonto izinyanga ezine. Ngemuva kwaloko, ukuqondiswa kwanyatheliswa kanye ngenyanga ngenani lesifundo sezinyanga ezingu-16. Iqembu lokulawula laliqondisiwe kanye ngenyanga ngenyanga ezingu-16.
Abahlanganyeli bahlolwe ngokusebenzisa ukuhlolwa okuhlukahlukene ezinyangeni ezingu-4, 10, nezinyanga ezingu-16. Nazi iziphumo zabacwaningi:
- Ezinyangeni ezine, umsebenzi jikelele uphuthukisiwe esimweni sokuguquguquka / ibhalansi / umsebenzi oqhathaniswa nalokho okusetshenziselwa ukuvivinya umzimba kanye namaqembu okulawula.
- Eminyakeni engu-4, 10, kanye nezinyanga ezingu-16, ukuhamba komnotho (okungukuthi, ukunyakaza kokusebenza kahle) kuthuthukisiwe eqenjini lokuzivocavoca aerobic uma kuqhathaniswa nalokho okuguquguqukayo / ibhalansi / umsebenzi weqembu.
- Ukulinganisa kwakunjalo phakathi kwamaqembu onke.
- Ezinyangeni ezingu-4 no-16, imisebenzi yokuphila kwansuku zonke ithuthukisiwe ngokuvumelana nezimo / ibhalansi / umsebenzi weqembu uma kuqhathaniswa neqembu elilawulayo.
Imiphumela yalolu cwaningo ibonisa ukuthi izinhlobo ezahlukene zokuzivocavoca zinika izinzuzo ezahlukahlukene kulabo abanesifo sikaParkinson. Izinhlelo zokukhuthazela zibonakala ziphazamisa izinzuzo zesikhathi eside kakhulu.
Ngokusho kukaSchenkman kanye nabalobi ababambisene nabo:
Imibiko efanelekayo evela kwabafundi abafundele inyanga-16 igcizelela ukuthi abantu badinga ukwesekwa okuqhubekayo ukuze balondoloze ukuzivocavoca njalo. Siyakhuthaza kakhulu ukuthi odokotela bathole izindlela zokusiza abantu abane-PD [i-Parkinson's disease] ukuthuthukisa nokugcina imikhuba yokuzivocavoca isikhathi eside, kuhlanganise nezinhlelo zokuzivocavoca ezifanele kanye nokuqhubeka nokuhlola nokusekela.
Ngokuphawula, lolu cwaningo lunezilinganiso zalo.
Okokuqala, iqembu lokulawula lisebenza ngokuzivocavoca ngoba kungabonakali ukuthi labo abahlanganyeli bangatholi noma yikuphi ukuzivocavoca. Ngamanye amazwi, nakuba iqembu "lokulalela" lingenakuzivocavoca phakathi nezinyanga ezingu-16, kuncoma ukuthi le nketho ingalimaza impilo. Ngokusho kwabacwaningi, jikelele ukuqondiswa kwe-Fitness Counts ekhishwe yi-National Parkinson Foundation kwaholela enzuzweni ethile, kodwa hhayi inzuzo enjengoba abahlanganyeli ezinhlelweni zokuzivocavoca ezithintekayo ezihilela ukuguquguquka / ukulinganisa / ukusebenza komzimba noma ukuvivinya umzimba.
Okwesibili, lolu cwaningo luqhutshwa eColorado, olulodwa lwezinkulumo eziseNyunyana. Kungenzeka ukuthi ababambiqhaza kulolu cwaningo babesebenzisa okungaphezulu kokuqala kunokuba abanye abantu bakwenza ngaleyo ndlela imiphumela engenzi lutho.
Okwesibili, abahlanganyeli emaqenjini amathathu bathola amanani ahlukene okunakekelwa ngabanye, okungase kuphazamise imiphumela.
Okokugcina, kwakunzima ukuhlola ukubambelela ekusetshenzisweni kwemigomo, futhi abacwaningi bathembele emigodini yomsebenzi-hhayi abaqaphi bokusebenza-ukwenza izinqumo ezinjalo.
Ukuzivocavoca okuphezulu kakhulu kanye nezifo zikaPasinson
Isifundo ku-Parkinson Izifo Zokuzivocavoca (SPARX) kwakuyisigaba sesi-2, isilingo esiphuthumayo somtholampilo esenziwa nguSchenkman kanye nozakwethu phakathi kukaMeyi 2012 noNovemba 2015. Abahlanganyeli ekuvivinyweni bahlolwe emva kwezinyanga eziyisithupha.
Esigamekweni se-SPARX, abathintekayo abangu-128 abanesifo sikaParkinson abaphakathi kweminyaka engama-40 no-80 babehlukaniswe ngamaqembu amathathu.
Iqembu lokuqala lokuhlola laqala ukuvivinya umzimba, iqembu lesibili lokuhlola lenza umsebenzi olinganiselayo, futhi amalungu eqembu lokulawula ayebhalwe ohlwini lokuzivocavoca esikhathini esizayo. (Futhi, bekungeke kube khona ukuphika ukuphika iqembu lokulawula ithuba lokuzivocavoca.)
Ngokuphawula, abahlanganyeli ocwaningweni babhekwa ukuthi banesifo sika de novo Parkinson (okungukuthi, esitholakale eminyakeni emihlanu eyedlule) futhi kwakungalindelekile ukuthi badinga imithi ye-dopaminergic (antiparkinson) ngesikhathi sezinyanga eziyisithupha zokubamba iqhaza kwabo. Ngaphezu kwalokho, akekho omunye wabathintekayo owake wahlanganyela ngokuzivocavoca-noma ukuvivinya umzimba.
Ukuzivocavoca kakhulu kwakunezinsuku ezine ngesonto kwi-rollreader ngamaphesenti angu-80 kuya kuma-85% wezinga eliphezulu lenhliziyo. Ukuzivocavoca umzimba okuphindaphindiwe kwenzeka izikhathi ezine ngesonto kepha phakathi kwamaphesenti angu-60 no-65% isilinganiso senhliziyo esikhulu.
Inhloso yesigaba sesi-2 se-SPARX kwakuwukuthi ngabe iziguli ezinezifo zikaParkinson zingahlanganyela ngokuphepha ngokuzivocavoca kakhulu. Abacwaningi abazange banqume ukuthi ukuzivocavoca umzimba phakathi kuka-80% no-85% wezinga lokushaya kwenhliziyo empeleni kubangele ukuhlomula komtholampilo kulabo abanesifo se-de novo Parkinson. Ekugcineni, abacwaningi babe nesithakazelo ekunqumeni ukuthi ukuvivinya umzimba okuphezulu kungavivinywa ekuvivinyeni kwesigaba sesi-3. Lezi zivivinyo zesigaba sesi-3 zizobe zihlola izinzuzo ezikhona zalokhu kungenelela.
Ngokusho kukaSchenkman kanye nabalobi ababambisene nabo:
Esinye sezici ezikhawulayo zokuthuthela ezivivinyweni zesigaba sesi-3 ukuthi i-dose efanele yokuzivocavoca ingakabe isetshenziselwa noma yimuphi umqondo wokuzivocavoca. Ukuzivocavoca kubeka ukuzibophezela okukhulu kokuzibandakanya kwesikhathi kanye nomzamo uma kuqhathaniswa nokungenelela kwe-pharmacologic. Ukuklanywa kokungabi nalutho kwakusetshenziselwa ukucacisa ukuthi ngabe ukuhlolwa okwengeziwe komthamo wokuzivocavoca othize kuqinisekiswe yini, kuveza indlela yokunquma ngokufanele umthamo ofanelekile ngaphambi kokuba uqhubekele phambili esigabeni sokuqala sokuvivinya umzimba ku-Parkinson. Ukutholakala kokungabi namfuyo kokusebenza okuphakeme kwamathambo wokugadla kufanele kushukumise insimu phambili kakhulu.
Ucwaningo lwe-SPARX lube nokulinganiselwa.
Okokuqala, ukuvivinya umzimba ngamandla kwenziwa kuphela kwi-stread and hhayi ukusebenzisa ezinye izinhlobo zokusebenzisa izinto zokuzivivinya.
Okwesibili, isivinini nesisindo sokugubha isisindo sashintsha ukuze kusetshenziswe ukuvivinya umzimba; Kodwa-ke, akucaci ukuthi yikuphi noma kokubili kwalezi ziguquko kungathuthukisa izimpawu zomgwaqo esibhedlela sikaParkinson.
Okwesithathu, akucaci ukuthi ukuhlanganisa kanjani ukuqhutshwa kwesisindo sokunyathelisa okunamandla nokunye ukungenelela kwe-physiotherapy ngenzuzo eyaziwayo kulabo abanesifo sika-Parkinson, njenge-Tai Chi noma ukuqeqeshwa kwamandla, kungabangela inzuzo enkulu yomtholampilo.
Izwi elivela
Siyazi ukuthi ukuvivinya umzimba kusiza abantu abane-Parkinson's disease. Ucwaningo olusha luveza ukuthi ukuvivinya umzimba okunamandla kakhulu kungase kubekwe ngokuphepha iziguli ezine-mildins ye-Parkinson nokuthi abantu abanezifo ezihlukahlukene ze-Parkinson baqala ukuzuza ezinhlobonhlobo zemithi yokuzivocavoca, kuhlanganise nezimo eziguquguqukayo, ibhalansi kanye ne-aerobic.
Ucwaningo olwengeziwe luzodingeka lwenziwe ukuze luzuze izinzuzo eziqondile zokuzivocavoca okukhulu. Uma wena noma othandekayo uthola ukuthi unesifo sikaParkinson, sicela uxhumane nodokotela wakho mayelana nokuthi yiziphi izinhlobo zokuzivocavoca ezihamba phambili kuwe.
> Imithombo:
> Izifo zikaPasinson. Ku: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. I-Manual yezokwelapha yakwaHarrison, e- New York, NY: McGraw-Hill.
> Izifo zikaPasinson. I-Medline Plus. https://medlineplus.gov/parkinsonsdisease.html.
> Schenkman M, et al. Umphumela we-High-Intensity Treadmill Ukuzivocavoca Ngezimpawu Zezimoto Ezigulane Nezifo ZaseDevovo Parkinson Isigaba sesi-2 se-Randomised Clinical Trial. I-JAMA Neurology. NgoDisemba 11, 2017. kufanele: 10.1001 / jamaneurol.2017.3517.
> Schenkman M, et al. Ukuzivocavoca Abantu Esigabeni Sokuqala-noma Esiphakathi Nezifo Zase-Parkinson: Isivivinyo Esilawulwa Ngenyanga Eyishumi Nama-Random. Ukwelashwa Kwemvelo. 2012; 92 (11): 1395-1410. i-doi: 10.2522 / ptj.20110472.