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Meta-Analysis
. 2019 Dec 18;17(1):31.
doi: 10.3390/ijerph17010031.

The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-analysis

Xiaohu Jin  1 , Lin Wang  1 , Shijie Liu  2 , Lin Zhu  3 , Paul Dinneen Loprinzi  4 , Xin Fan  5
Affiliations
Meta-Analysis

The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-analysis

Xiaohu Jin et al. Int J Environ Res Public Health. .

Abstract

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson's patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = -0.61, p < 0.001), TUG (SMD = -1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = -1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG（I2 = 29%）, Balance（I2 = 16%） and QoL（I2 = 35%）, it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson's disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

Keywords: Health Qigong; Parkinson disease; Tai Chi; Yoga; meta-analysis; quality of life.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Flowchart displaying study selection.
Figure 2
Figure 2
Funnel plot for UPDRS rating results after removing outliers.
Figure 3
Figure 3
Effects of mind-body exercises on UPDRS Rating Results.
Figure 4
Figure 4
Funnel plot for TUG test score results after removing outliers.
Figure 5
Figure 5
Effects of mind-body exercises on timed up and go test score results.
Figure 6
Figure 6
Funnel plot for balance function score results after removing outliers.
Figure 7
Figure 7
Effects of mind-body exercises on balance function score results.
Figure 8
Figure 8
Funnel plot for depression test score results after removing outliers.
Figure 9
Figure 9
Effects of mind-body exercises on depression test score results.
Figure 10
Figure 10
Funnel plot for quality of life test score results after removing outliers.
Figure 11
Figure 11
Effects of mind-body exercises on quality of life test score results.
See this image and copyright information in PMC

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