Effects and parameters of community-based exercise on motor symptoms in Parkinson’s disease: a meta-analysis

Abstract

Background Community-based exercise is a continuation and complement to inpatient rehabilitation for Parkinson's disease and does not require a professional physical therapist or equipment. The effects, parameters, and forms of each exercise are diverse, and the effect is affected by many factors. A meta-analysis was conducted to determine the effect and the best parameters for improving motor symptoms and to explore the possible factors affecting the effect of community-based exercise. Methods We conducted a comprehensive search of six databases: PEDro, PubMed/Medline, CENTRAL, Scopus, Embase, and WOS. Studies that compared community-based exercise with usual care were included. The intervention mainly included dance, Chinese martial arts, Nordic walking, and home-based exercise. The primary outcome measure was the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) score. The mean difference (95% CI) was used to calculate the treatment outcomes of continuous outcome variables, and the I2 statistic was used to estimate the heterogeneity of the statistical analysis. We conducted subgroup analysis and meta-regression analysis to determine the optimal parameters and the most important influencing factors of the exercise effect. Results Twenty-two studies that enrolled a total of 809 subjects were included in the analysis. Exercise had a positive effect on the UPDRS-III (MD = -5.83; 95% CI, -8.29 to -3.37), Timed Up and Go test (MD = -2.22; 95% CI -3.02 to -1.42), UPDRS ((MD = -7.80; 95% CI -10.98 to -6.42), 6-Minute Walk Test (MD = 68.81; 95% CI, 32.14 to 105.48), and Berg Balance Scale (MD = 4.52; 95% CI, 2.72 to 5.78) scores. However, the heterogeneity of each included study was obvious. Weekly frequency, age, and duration of treatment were all factors that potentially influenced the effect. Conclusions This meta-analysis suggests that community-based exercise may benefit motor function in patients with PD. The most commonly used modalities of exercise were tango and tai chi, and the most common prescription was 60 min twice a week. Future studies should consider the influence of age, duration of treatment, and weekly frequency on the effect of exercise. PROSPERO trial registration number CRD42022327162.

A personal exploration of oral health in Parkinson's disease through the eyes of a multifaceted authority

“…In one of the most recent meta-analyses on the effects of home-based exercise and PD, Yang et al's review reported a small effect across all types of exercise in relieving motor symptoms in PD patients, provided that the training period was no less than 8 weeks with no <30 training sessions within that period. 30 Hence, increasing exercise periods is indeed a promising recommendation for PD patients. However, the possible implications of exercise for oral health require more attention in future research, given the assumption that better oral self-care would be possible when motor symptoms are reduced due to physical training programs.…”

“…In one of the most recent meta‐analyses on the effects of home‐based exercise and PD, Yang et al. 's review reported a small effect across all types of exercise in relieving motor symptoms in PD patients, provided that the training period was no less than 8 weeks with no <30 training sessions within that period 30 . Hence, increasing exercise periods is indeed a promising recommendation for PD patients.…”

Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease

“…[8][9][10] It was reported that proper aerobic exercise training could potentially delay PD progression, and long-term community-and-home-based exercise interventions were demonstrated effective and safe for PD patients. [10][11][12][13][14] In addition, Flynn et al [12] reviewed and analyzed 16 clinical trials and concluded that home-based prescribed exercise achieved similar improvements to equivalent center-based exercise in terms of gait speed and balance-related activities in individuals with PD. Nonetheless, the specific mechanism underlying the exercise-induced positive effects in PD still warrants further exploration.…”

Acute effects of different Tai Chi practice protocols on cardiac autonomic modulation

“…Moreover, its versatility allows it to be practiced individually or in group settings, making it accessible to individuals with busy lifestyles and fostering social engagement 15 . Furthermore, Tai Chi requires no special equipment and can be enjoyed by virtually anyone, anywhere 16 .…”