Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 May;37(5):328-352.
doi: 10.1177/15459683231172752. Epub 2023 May 11.

Does Exercise Attenuate Disease Progression in People With Parkinson's Disease? A Systematic Review With Meta-Analyses

Jiecheng A Li  1 , Marte B Loevaas  1 , Catherine Guan  2 , Lina Goh  1 , Natalie E Allen  1 , Margaret K Y Mak  3 , Jinglei Lv  4   5 , Serene S Paul  1
Affiliations
Meta-Analysis

Does Exercise Attenuate Disease Progression in People With Parkinson's Disease? A Systematic Review With Meta-Analyses

Jiecheng A Li et al. Neurorehabil Neural Repair. 2023 May.

Abstract

Introduction: Exercise has many benefits for people with Parkinson's disease (PD) and has been suggested to modify PD progression, but robust evidence supporting this is lacking.

Objective: This systematic review (PROSPERO registration: CRD42020169999) investigated whether exercise may have neuroplastic effects indicative of attenuating PD progression.

Methods: Six databases were searched for randomized controlled trials (RCTs) that compared the effect of exercise to control (no or sham exercise) or to another form of exercise, on indicators of PD progression (eg, brain-derived neurotrophic factor [BDNF], brain activation, "off" Unified Parkinson's Disease Rating Scale [UPDRS] scores). Trial quality was assessed using the Physiotherapy Evidence Database Scale. Random-effects meta-analyses were performed where at least 3 comparable trials reported the same outcome; remaining results were synthesized narratively.

Results: Forty-nine exercise trials involving 2104 PD participants were included. Compared to control, exercise improved "off" UPDRS motor scores (Hedge's g -0.39, 95% CI: -0.65 to -0.13, P = .003) and BDNF concentration (Hedge's g 0.54, 95% CI: 0.10-0.98, P = .02), with low to very low certainty of evidence, respectively. Narrative synthesis for the remaining outcomes suggested that compared to control, exercise may have neuroplastic effects. The exercise versus exercise comparisons were too heterogenous to enable pooling of results.

Discussion: This review provides limited evidence that exercise may have an attenuating effect on potential markers of PD progression. Further large RCTs are warranted to explore differential effects by exercise type, dose and PD stage, and should report on a core set of outcomes indicative of PD progression.

Keywords: Parkinson’s disease; disease course; exercise; neuroprotection; systematic review.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram for new systematic reviews which included searches of databases, registers, and other sources.
Figure 2.
Figure 2.
Quality of included trials based on the Physiotherapy Evidence Database (PEDro) criteria and scores.
Figure 3.
Figure 3.
Forest plots of the effects of exercise versus control on Movement Disorders Society/Unified Parkinson’s Disease Rating Scale (MDS/UPDRS) “off” motor scores. Panel (A) shows the overall results and (B) the subgroup analysis.
Figure 4.
Figure 4.
Forest plots of the effects of exercise versus control on brain-derived neurotrophic factor (BDNF) concentration. Panel (A) shows the overall results and (B) the subgroup analysis.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sveinbjornsdottir S. The clinical symptoms of Parkinson’s disease. J Neurochem. 2016;139(suppl 1):318-324. doi:10.1111/jnc.13691 - DOI - PubMed
    1. Hariz GM, Forsgren L. Activities of daily living and quality of life in persons with newly diagnosed Parkinson’s disease according to subtype of disease, and in comparison to healthy controls. Acta Neurol Scand. 2011;123(1):20-27. doi:10.1111/j.1600-0404.2010.01344.x - DOI - PubMed
    1. Reinoso G, Allen JC, Jr., Au WL, Seah SH, Tay KY, Tan LC. Clinical evolution of Parkinson’s disease and prognostic factors affecting motor progression: 9-year follow-up study. Eur J Neurol. 2015;22(3):457-463. doi:10.1111/ene.12476 - DOI - PubMed
    1. Pang MY. Physiotherapy management of Parkinson’s disease. J Physiother. 2021;67(3):163-176. doi:10.1016/j.jphys.2021.06.004 - DOI - PubMed
    1. Segura C, Eraso M, Bonilla J, et al.. Effect of a high-intensity tandem bicycle exercise program on clinical severity, functional magnetic resonance imaging, and plasma biomarkers in Parkinson’s disease. Front Neurol. 2020;11:656. doi:10.3389/fneur.2020.00656 - PMC - PubMed

Substances