Effect of Long-term Exercise Therapy on Motor Symptoms in Parkinson Disease Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Study Goal
The researchers aimed to assess the effectiveness of long-term exercise therapy (≥12 weeks) for improving motor symptoms in patients with Parkinson disease, with a focus on optimizing improvements through exercise type and dose.
Results Summary
Walking capacity outcomes did not improve after Tai Chi and resistance training but did improve after dance. The study found that increasing intervention duration or session length enhanced exercise effect sizes, with optimal benefits observed at a frequency of 2 times per week.
Population
Patients with Parkinson disease (total of 1243 participants across 26 studies).
Effective Dosage
Frequency of 2 times per week (optimal benefit).
Duration
≥12 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Tai Chi | increase | physical function and functional mobility | patients with Parkinson disease | - | provide significant improvements | #1 |
resistance training | increase | physical function and functional mobility | patients with Parkinson disease | - | provide significant improvements | #2 |
dance | increase | physical function and functional mobility | patients with Parkinson disease | - | provide significant improvements | #3 |
Tai Chi | increase | balance | patients with Parkinson disease | - | result in balance benefits | #4 |
dance | increase | balance | patients with Parkinson disease | - | result in balance benefits | #5 |
Tai Chi | no change | walking capacity outcomes | patients with Parkinson disease | - | did not improve | #6 |
resistance training | no change | walking capacity outcomes | patients with Parkinson disease | - | did not improve | #7 |
dance | increase | walking capacity outcomes | patients with Parkinson disease | - | did improve | #8 |
long-term exercise therapy | increase | effect sizes of exercise on these outcomes | patients with Parkinson disease | - | increased | #9 |
long-term exercise therapy | increase | these outcomes | patients with Parkinson disease | - | higher benefits | #10 |
long-term exercise therapy | increase | motor symptoms | patients with Parkinson disease | - | is an effective treatment for improving | #11 |
dance | neutral | - | patients with Parkinson disease | - | being an ideal exercise choice | #12 |
OBJECTIVES: The aims of the study were to assess the effectiveness of long-term exercise therapy (≥12 wks) for patients with Parkinson disease and to derive specific suggestions on how the motor symptom improvements can be optimized by exercise type and exercise dose. DESIGN: The PubMed, Web of Science, Cochrane Central Register, Embase, Scopus, and CNKI databases were searched up to January 2021 for randomized controlled trials focusing on the effects of long-term exercise for Parkinson disease. Two researchers independently evaluated the quality of papers using the PEDro scale. Twenty-six studies with a total of 1243 participants were included. RESULTS: Tai Chi, resistance training, and dance provide significant improvements in physical function and functional mobility. Furthermore, Tai Chi and dance result in balance benefits. However, walking capacity outcomes did not improve after Tai Chi and resistance training but did improve after dance. With an increase in the intervention duration or length of each session, the effect sizes of exercise on these outcomes increased; higher benefits of exercise on these outcomes were observed at a frequency of 2 times/wk. CONCLUSIONS: Long-term exercise therapy is an effective treatment for improving motor symptoms, with dance being an ideal exercise choice. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Recognize that long-term exercise slows clinical progression of motor symptoms in patients with Parkinson disease; (2) Acquire knowledge regarding the effectiveness of long-term exercise therapy on motor symptoms in Parkinson disease; and (3) Incorporate specific suggestions on dose-response relationships of different exercise therapy on motor symptoms in Parkinson disease. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.