Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: A systematic review of randomized controlled trials of the last 10 years

Silva, Franciele Cascaes da; Iop, Rodrigo da Rosa; Oliveira, Laiana Cândido de; Boll, Alice Mathea; Alvarenga, José Gustavo Souza de; Filho, Paulo José Barbosa Gutierres; Melo, Lídia Mara Aguiar Bezerra de; Xavier, André Junqueira; Silva, Rudney da

doi:10.1371/journal.pone.0193113

Cited by 136 publications

(125 citation statements)

References 88 publications

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“…In contrast, research on the efficacy of physical exercise in treatment of other brain disorders is still in its infancy and therefore not part of the standard care. Although several studies have investigated the effect of physical exercise in different chronic brain disorders such as Alzheimer's disease (AD) [17,18], multiple sclerosis (MS) [19][20][21], Parkinson's disease (PD) [22,23], Schizophrenia (Sz) [24,25] and unipolar depression (UD) [26][27][28], results and mainly recommendations for clinical practice have been highly diverse [29]. As a consequence, current evidence for efficacy of exercise therapy is still disputed and exercise is not part of the regular care offer for patients with aforementioned disorders in most countries.…”

Section: Introductionmentioning

confidence: 99%

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

et al. 2019

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We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer's disease, Huntington's disease, multiple sclerosis, Parkinson's disease, schizophrenia and unipolar depression. 122 studies (= k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms (k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory (k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning (k = 14, n = 977, ES = 0.15, p = 0.013), memory (k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed (k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose-response effect for exercise time (min/week) on depressive symptoms (β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose-response correlation. Exercise also improved several cognitive domains with small but significant effects.

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Section: Introductionmentioning

confidence: 99%

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

et al. 2019

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“…36 Exercise-based cardiac rehabilitation is a cornerstone of the secondary prevention of cardiovascular diseases, 37 and physical exercise programs can be beneficial for cognitive function in PD. 38 Therefore, in clinical settings, it may be important to promote physical activity at early stages of disease.…”

Section: Discussionmentioning

confidence: 99%

“…34 WML was also suggested to underpin, at least to some extent, the antiparkinsonian treatment-resistant symptoms that develop during the course of PD, such as gait difficulties and postural instability. 38 Therefore, in clinical settings, it may be important to promote physical activity at early stages of disease. 36 Exercise-based cardiac rehabilitation is a cornerstone of the secondary prevention of cardiovascular diseases, 37 and physical exercise programs can be beneficial for cognitive function in PD.…”

Section: Whole Group (N = 64) No Falls or Near Falls (N = 29) Falls Amentioning

confidence: 99%

Dyskinesia and FAB score predict future falling in Parkinson's disease

et al. 2019

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Parkinson's disease (PD) is the world's second most common agerelated neurodegenerative disorder. Given the tendency for longer life expectancy and that the risk of PD increases with age, the number of people with PD is expected to double by the year 2030. 1 In PD, degeneration of the dopaminergic pathways results in striatal dopamine deficiency. The cardinal signs of disease are as follows:bradykinesia, muscle rigidity, resting tremor, and postural instability.In addition to these classic motor symptoms, non-motor features (eg, cognitive impairment, dizziness, and orthostatic hypotension) also occur. The core and first-choice therapy is dopaminergic medication (levodopa) that targets the neurotransmitter imbalance within the basal ganglia circuits. Complications of therapy such as dyskinesia (involuntary movements) and "off" periods (fluctuating drug response) often develop over time. 2 Falls and balance problems are common already in the early stages of disease 3,4 and progress over time. 5 A history of falls is the strongest predictor of future falls in PD. 6 However, it was suggested that prediction of both near falls and falls has greater clinical value than prediction of falls alone if you aim at working proactively. 7 Furthermore, fall prediction models, in order to be applicable, useful, and practical for routine clinical use, need to have sufficient discriminant ability 8,9 and must be easy to implement. 10 To this A growing body of research highlights the importance of cognition for prediction of falls in Parkinson's disease (PD). However, a previously proposed prediction model for future near falls and falls in PD, which includes history of near falls, tandem gait, and retropulsion, was developed without considering cognitive impairment.

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“…Treadmill and bicycle intervention can be used when performing against resistance [43][44][45]47]. Da Silva and her coworkers [48] suggest a long-term effect in nonmotor signs and symptoms of Parkinson's disease, especially in cognitive aspects, in individuals performing treadmill training, just as Ferreira and her coworkers [49] showed that resistance training was an effective intervention in the reduction of anxiety symptoms and improved the quality of life in this population.…”

Section: Resistance Training and Muscle Strengthmentioning

confidence: 99%

“…This approach can be used with or without a body-weight-support system, depending on the motor difficulties of the individual with Parkinson's disease. It may be related with improvement in motor signs like motor action, balance, and gait, although the evidence is not so strong [2,48].…”

Section: Aerobic Training: Treadmill Cycling Free Walking Dance Amentioning

confidence: 99%

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

Vasconcelos¹

2020

Physical Therapy Effectiveness

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Parkinson's disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. However, it is important to develop and to fortify the physical therapy approach so that we can provide stronger evidence about our practice.

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Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: A systematic review of randomized controlled trials of the last 10 years

Cited by 136 publications

References 88 publications

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials

Dyskinesia and FAB score predict future falling in Parkinson's disease

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

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