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Review
. 2022 Oct 31;8(1):146.
doi: 10.1038/s41531-022-00418-4.

A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson's disease

Kai Zhen #  1   2 , Shiyan Zhang #  1   2 , Xifeng Tao  2 , Gen Li  2 , Yuanyuan Lv  3   4 , Laikang Yu  5   6
Affiliations
Review

A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson's disease

Kai Zhen et al. NPJ Parkinsons Dis. .

Abstract

Previous studies have shown that aerobic exercise is an effective way to improve symptoms of Parkinson's disease (PD). The aim of this study [PROSPERO CRD42022340730] was to explore the effects of aerobic exercises on balance, gait, motor function, and quality of life in PD patients. Searches were performed in PubMed, Web of Science, and EBSCO electronic databases. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1287 search records initially identified, 20 studies were considered eligible for systematic review and meta-analysis. There was a significant effect of aerobic exercise on improving timed up and go test [standardized mean difference (SMD), -0.41 (95% CI, -0.61 to -0.22), p < 0.00001], Berg Balance Scale [0.99 (95% CI, 0.76 to 1.23), p < 0.00001], stride/step length [0.32 (95% CI, 0.03 to 0.61), p = 0.03], gait velocity [0.49 (95% CI, 0.20 to 0.78), p = 0.0009], Unified Parkinson's Disease Rating Scale Part-III [-0.40 (95% CI, -0.55 to -0.24), p < 0.00001], and 6-minute walking test [0.35 (95% CI, 0.13 to 0.56), p = 0.002] in people with PD, but not in step cadence [-0.08 (95% CI, -0.43 to 0.27), p = 0.65] and Parkinson's Disease Questionnaire-39 [-0.113 (95% CI, -0.39 to 0.13), p = 0.32]. Aerobic exercise had beneficial effects in improving balance, gait (velocity and stride/step length), and motor function in PD patients. However, aerobic exercise had no significant associations with the step cadence and quality of life in PD patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of study selection.
Fig. 2
Fig. 2. Results of Cochrane risk of bias tool.
Above: Risk of bias summary: review authors’ judgments about each risk of bias item for each included study. Below: Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
Fig. 3
Fig. 3. Funnel plot.
a Funnel plot for TUG. b Funnel plot for BBS. c Funnel plot for gait. d Funnel plot for UPDRS-III. e Funnel plot for 6MWT. f Funnel plot for PDQ-39.
Fig. 4
Fig. 4. Meta-analysis results of the effect of aerobic exercise on TUG in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the effect size of each study summarized as SMD. The size of the shaded squares was proportional to the percentage weight of each study. Horizontal lines represented the 95% CI and the vertical line represented the overall effect.
Fig. 5
Fig. 5. Meta-analysis results of the effect of aerobic exercise on BBS in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the size of the effect of each study summarized as SMD. The size of the shaded square was proportional to the percentage weight of each study. Horizontal lines represented the 95% CI and the vertical dashed line represented the overall effect.
Fig. 6
Fig. 6. Meta-analysis results of the effect of aerobic exercise on gait in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the size of the effect of each study summarized as SMD. The size of the shaded square was proportional to the percentage weight of each study. Horizontal line represented the 95% CI and the vertical dashed line represented the overall effect.
Fig. 7
Fig. 7. Meta-analysis results of the effect of aerobic exercise on UPDRS-III in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the size of the effect of each study summarized as SMD. The size of the shaded square was proportional to the percentage weight of each study. Horizontal line represented the 95% CI and the vertical dashed line represented the overall effect.
Fig. 8
Fig. 8. Meta-analysis results of the effect of aerobic exercise on 6MWT in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the size of the effect of each study summarized as SMD. The size of the shaded square was proportional to the percentage weight of each study. Horizontal line represented the 95% CI and the vertical dashed line represented the overall effect.
Fig. 9
Fig. 9. Meta-analysis results of the effect of aerobic exercise on PDQ-39 in people with PD.
The pooled estimates were obtained from fixed effects analysis. Diamonds indicated the size of the effect of each study summarized as SMD. The size of the shaded square was proportional to the percentage weight of each study. Horizontal line represented the 95% CI and the vertical dashed line represented the overall effect.
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