Effects of Aerobic Exercise and Mind-Body Exercise in Parkinson’s Disease: A Mixed-Treatment Comparison Analysis

Abstract

Background/Objectives: Aerobic exercise and mind-body exercise, are vital for improving motor and non-motor functional performance of Parkinson’s disease (PD). However, evidence-based recommendations on which type of exercise is most suitable for each individual are still lacking. Therefore, we conduct a network meta-analysis to assess the relative efficacy of aerobic and mind-body exercise on motor function and non-motor symptoms in Parkinson’s disease and to determine which of these therapies are the most suitable.Design: A network meta-analysis and dose-response analysis.Setting and Participants: Medline, Embase (all via Ovid), and the Cochrane Central Register of Controlled Trials were comprehensively searched for related trials through April 2021.Measurements: Study quality was evaluated using the Cochrane Risk of Bias Tool. The effect sizes of continuous outcomes were calculated using mean differences (MDs) or standardized mean differences (SMDs). A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of the therapies. The dose-response relationship was determined based on metaregression and SUCRA.Results: Fifty-two trials with 1971 patients evaluating six different therapies were identified. For the UPDRS-motor score and TUG score, yoga all ranked highest (SUCRA = 92.8%, 92.6%, respectively). The SUCRA indicated that walking may best improve the BBS score (SUCRA = 90.2%). Depression, cognitive and activities of daily living scores were significantly improved by yoga (SUCRA: 86.3, 95.1, and 79.5%, respectively). In the dose-response analysis, 60-min sessions, two times a week might be the most suitable dose of yoga for reducing the UPDRS-motor score of PD patients.Conclusion: Yoga and walking are important options for increasing functional mobility and balance function, and yoga might be particularly effective for decreasing depressive symptoms and cognitive impairment and improving activities of daily living in PD. The potential optimal dose of yoga for enhancing motor ability in PD patients is 60-min sessions, two times a week.Registration: PROSPERO CRD42021224823.

Effectiveness of different exercises in improving postural balance among Parkinson's disease patients: a systematic review and network meta-analysis

“…Firstly, compared with other exercise interventions, these three exercise interventions are combined with auditory or visual stimulation. Consistent with earlier investigations (Wu et al, 2021 ; Hao et al, 2022 ; Yang et al, 2022 ), which also emphasized mobility and balance, the findings suggest that the combination of auditory or visual exercise may be more beneficial in facilitating interventions for patients with Parkinson's disease. According to Capato et al ( 2020 ), the addition of rhythmic auditory stimulation may increase the effectiveness of rehabilitation training by enhancing attention and task prioritization, which would more effectively stimulate residual motor-cognitive function in Parkinson's disease patients than the conventional multimodal balance training.…”

Effects of Ten Different Exercise Interventions on Motor Function in Parkinson’s Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials

“…The TUGT test is often used to test lower limb muscle strength in older people due to its ease of use and sensitivity [ 97 ], and our study shows that yoga and resistance training have unparalleled advantages in reducing TUGT testing times in people with Parkinson’s disease, which is in line with previous studies. The results are the same as in the original study [ 98 ]. At the same time, however, we made the further hypothesis that yoga combined with resistance training may be more beneficial than yoga or resistance training alone, with resistance training being beneficial in slowing muscle strength loss and promoting skeletal muscle hypertrophy [ 99 ] and yoga training being beneficial in maintaining joint flexibility and ligament elasticity [ 100 ], and that combining the two at the right dose (exercise duration and intensity) may have better effects.…”

Effects of Exercise on Depressive Symptoms in Patients With Parkinson Disease

“…Another study using network meta-analysis assessed the comparative effectiveness of aerobic and mind-body exercises on motor and nonmotor symptoms in patients with PD. 32 However, the study included only 12 studies for depressive symptoms and failed to show meaningful overall effects of physical exercise on the symptoms.…”