The effects of exercise interventions on Parkinson’s disease: A Bayesian network meta-analysis

Tang, Lijun; Fang, Yingjie; Yin, Jianping

doi:10.1016/j.jocn.2019.08.092

Cited by 47 publications

(36 citation statements)

References 40 publications

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“…Studies in China and across the world have found that various non-pharmacological treatment methods can significantly affect both the motor and non-motor symptoms of PD (6). Among these methods, exercise therapy can strengthen the balance and gait ability of PD patients, improve negative emotions, and enhance the quality of life (7)(8)(9). It also offers further advantages including being efficient, economical, and accessible, and has been widely used in clinical, community, and auxiliary treatment.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of moderate aerobic exercise for patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials

Li¹,

Song²,

Shen³

et al. 2021

Ann Palliat Med

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Background: Exercise therapy is an important component of non-drug treatment for Parkinson's disease (PD). However, the impact of moderate aerobic exercise on PD remains unclear. The purpose of this systematic review was to evaluate the efficacy and safety of moderate aerobic exercise for patients with PD. Methods: Databases including the Cochrane Library, PubMed, Web of Science, EMBASE, Chinese Biomedical Literature (CBM) Database, Chinese National Knowledge Infrastructure (CNKI), WanFang, and the Weipu Database for Chinese Technical Periodicals (VIP) were searched electronically from the date of inception of the database to June 2020 to recruit relevant randomized controlled trials (RCTs) investigating the efficacy and safety of moderate aerobic exercise on balance and other symptoms in patients with PD. Literature screening, data extraction, and quality evaluation were carried out. Revman5.1 (http:// ims.cochrane.org/revman) was used for data analysis. Results: In total, nine RCTs with 444 patients were included in this study. Most of the included trials had a low risk of bias and high methodological quality. The meta-analysis suggested that moderate aerobic exercise is effective in improving balance [weighted mean difference (WMD) =−0.42, 95% confidence interval (CI): −0.59 to −0.25, P<0.001] and gait (WMD =49.97, 95% CI: 17.84-82.10, P<0.001) in patients with PD, but not in motor symptoms (WMD =−2.14, 95% CI: −4.86-0.58, P=0.12). Subgroup analysis showed that the improvement in the quality of life of PD patients was affected by different types of exercise, and the treadmill subgroup improved significantly (WMD =−3.90, 95% CI: −5.02 to −2.78), P<0.001).Conclusions: On the whole, moderate aerobic exercise effectively improves balance and gait in patients with PD, but the effect on motor symptoms is not obvious. Different exercise styles have varying effects on the quality of life of PD patients. It is necessary to standardize the exercise program further and carry out indepth research in the future.

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Section: Introductionmentioning

confidence: 99%

The efficacy and safety of moderate aerobic exercise for patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials

Li¹,

Song²,

Shen³

et al. 2021

Ann Palliat Med

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“…If decreases in mitochondrial capacity influence exercise capacity, this would have a clinical impact as exercise is considered beneficial in slowing the progression of the disease or optimizing function in the face of the disease. 3,10,11 The NIRS approach to measuring mitochondrial capacity has been used to evaluate patients with multiple sclerosis (MS) and amyloid lateral sclerosis (ALS). 6 Mitochondrial capacity was considerably lower in those populations relative to controls than what was found for people with PD.…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial Capacity and Muscle Endurance in Individuals with Parkinson’s Disease

Sharma

Ware²,

McCully³

2021

MRAJ

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Introduction: Parkinson's disease (PD) is associated with loss of motor control and difficulty exercising. This study measured skeletal muscle mitochondrial capacity and endurance in individuals with and without PD using novel non-invasive methods. We hypothesized that individuals with PD will have decreased mitochondrial capacity, reduced oxygen recovery, and decreased endurance compared to controls. Methods: Eight participants with PD and nine healthy controls were tested. Mitochondrial capacity was measured as the rate of recovery of muscle metabolism after electrical stimulation using near-infrared spectroscopy (NIRS) and repeated short arterial occlusions. Oxygen recovery was measured as the half time of recovery of oxygen levels after 5 minutes of ischemia. Muscle endurance was determined from changes in twitch contraction acceleration during electrical stimulation at 2, 4, and 6 Hz. Results: Mitochondrial capacity was lower in individuals with PD compared to controls (1.5±0.1min-1 vs. 1.7±0.1min-1, p=0.02). Individuals with PD had slower oxygen recovery after ischemia compared to controls (8.9±2.3s vs. 5.4±0.8s, p=0.01). Endurance was not different between groups at 6 Hz (PD vs controls: 58±23% vs. 69±16%, p=0.34). The effect sizes for mitochondrial capacity and oxygen recovery were large (Cohen's d >0.8). The Cohen's d for endurance was 1.11. Conclusion: Individuals with PD had slight impairments in mitochondrial capacity and blood flow but did not have reduced muscle endurance. While our study suggests that muscle metabolic dysfunction may play a minor role in exercise intolerance in people with PD, it demonstrates the use of noninvasive technologies to evaluate muscle function in people with neurological disorders.

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“…20 Recent meta-analysis that investigated the efficacy of different exercises on PD included different types of training programmes like yoga, tango, dance, tai chi, RT, multimodal exercise training, aerobic exercise, qi gong, but no PT training. 21 Given that PT focuses on rapid movement speed by lowresistance training, it would be beneficial to examine its role on functional outcomes in subjects with PD. Indeed, further studies are needed to support the beneficial effects of different types of RT in subjects with PD and to investigate the superiority of PT in participants with PD comparing with other treatment strategies.…”

Section: Background and Rationalementioning

confidence: 99%

Section: Background and Rationalementioning

confidence: 99%

Effects of a power strength training using elastic resistance exercises on the motor and non-motor symptoms in patients with Parkinson’s disease H&Y 1–3: study protocol for a randomised controlled trial (PARK-BAND Study)

et al. 2020

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IntroductionParkinson’s disease (PD) is the second most common neurodegenerative disorder in Brazil. Physical activity is a complementary intervention in managing inherent declines associated with the disease like strength, balance, gait, and functionality and benefit health-related outcomes. Here, we report the PARK-BAND Study protocol, which aims to investigate potential benefits of power training using elastic devices in participants with PD. Our intervention will be provided in patients with PD using elastic devices like elastic bands and tubes. Therefore, we used the term Park from Parkinson’s disease and band from elastic bands.Methods and analysisThis randomised single-blind single-centre two-arm parallel, superiority trial will include 50 participants with PD attending the clinical setting. Those who meet the eligibility criteria and provide consent to participate will be randomised in a 1:1 ratio to either the exercise group, which will receive power training programme or the health education group, which will receive the education programme. Randomisation will be performed by permuted block randomisation with a block size of eight. Both groups will receive a 12-week intervention. The exercise group will have two sessions per week and the health education group will have one session per week. Changes from baseline in bradykinesia, as assessed by the Unified Parkinson's Disease Rating Scale motor examination subscore and physical functional performance, will be the primary outcomes. Secondary outcomes include other neurological, neurophysiological and physical variables, as well as the quality of life, depression, cognition, sleep quality and disturbances, assessed before and after interventions. We hypothesise that the exercise group will have greater improvement in primary and secondary outcomes than the health education group.Ethics and disseminationThe study is approved by the Research Ethics Committee of Hospital Universitário Walter Cantidio and all participants will provide their written informed consent (register number 91075318.1.0000.5045).Trial results will be disseminated via peer reviewed journal articles and conference presentations, reports for organisations involved with PD and for participants.Trial registration numberRegistro Brasileiro de Ensaios Clínicos Registry (RBR-5w2sqt); Pre-results.

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The effects of exercise interventions on Parkinson’s disease: A Bayesian network meta-analysis

Cited by 47 publications

References 40 publications

The efficacy and safety of moderate aerobic exercise for patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials

The efficacy and safety of moderate aerobic exercise for patients with Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials

Mitochondrial Capacity and Muscle Endurance in Individuals with Parkinson’s Disease

Effects of a power strength training using elastic resistance exercises on the motor and non-motor symptoms in patients with Parkinson’s disease H&Y 1–3: study protocol for a randomised controlled trial (PARK-BAND Study)

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