Abstract

Background:

Parkinson’s disease (PD) is a neurological condition characterized by the development of daily disabling symptoms. Although the architecture and design of a PD patient’s environment can hinder or facilitate full participation in daily activities, their putative role in the management of these patients has received little attention to date.

Objective:

We conducted a systematic review to evaluate the evidence of architectural and design features in the management of people with PD.

Methods:

An electronic database search of observational and experimental studies was conducted in MEDLINE and Embase from inception to May 2020, with two independent reviewers identifying the studies. Falls, fear of falling, postural instability, gait impairment/disability, and functional mobility were our outcomes of interest.

Results:

Thirty-six studies were included, among which nineteen were observational and seventeen were experimental studies (overall participants = 2,965). Pavement characteristics, notably unstable surfaces and level differences, were found to be a major cause of falling. Ground-based obstacles and confined/narrowed spaces were found to disturb gait, increase postural instability, and decrease functional mobility. Housing type did not appear to increase risk of falling, nor to significantly explain concerns about falling.

Conclusion:

Findings suggest a need to adjust architectural features of the surrounding space to ensure appropriate care and provide a safe environment to PD patients. More evidence about the impact of such modifications on PD outcomes is needed.

中文翻译：

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建筑和设计在帕金森病管理中的作用：系统评价。

摘要

背景：

帕金森病 (PD) 是一种神经系统疾病，其特征是出现日常致残症状。尽管 PD 患者环境的架构和设计可能会阻碍或促进全面参与日常活动，但他们在这些患者的管理中的假定作用迄今为止很少受到关注。

客观的：

我们进行了系统审查，以评估建筑和设计特征在 PD 患者管理中的证据。

方法：

从开始到 2020 年 5 月，在 MEDLINE 和 Embase 中对观察性和实验性研究进行了电子数据库搜索，两名独立审查员确定了这些研究。跌倒、害怕跌倒、姿势不稳定、步态障碍/残疾和功能性活动能力是我们感兴趣的结果。

结果：

纳入了 36 项研究，其中 19 项是观察性研究，17 项是实验性研究（总参与者 = 2,965）。路面特性，特别是不稳定的表面和水平差，被发现是导致跌倒的主要原因。发现地面障碍物和狭窄/狭窄的空间会干扰步态，增加姿势不稳定性，并降低功能流动性。住房类型似乎没有增加跌倒的风险，也没有显着解释对跌倒的担忧。

结论：

调查结果表明，需要调整周围空间的建筑特征，以确保适当的护理并为 PD 患者提供安全的环境。需要更多关于此类修改对 PD 结果影响的证据。