Official websites use. Share sensitive information only on official, secure websites. Physical exercise is effective in managing Parkinson's disease PD , but the relative benefit of different exercise types remains unclear. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. We included randomized controlled trials RCTs comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both.
Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 RoB 2 tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL.
We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. We included RCTs with a total of participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small mean 51, range from 10 to The NMAs on the severity of motor signs and QoL included data from 71 participants , and 55 participants trials, respectively.
Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group.
For both scales, higher scores denote higher symptom burden. Flexibility training might have a trivial or no effect on the severity of motor signs MD 2. No adverse events AEs occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls 18 studies and pain 10 studies. The evidence is very uncertain about the effect of physical exercise on the risk of adverse events very low confidence. We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions.
