OBJECTIVE: To evaluate and compare the effect of 3 intensive exercise therapy modalities -- resistance training (RT), endurance training (ET) and other intensive training modalities (OITM) -- in Parkinson's disease (PD). DESIGN: A systematic review and meta-analysis of randomized controlled trials. METHODS: A systematic literature search was conducted (Embase, PubMed, CINAHL, SPORTDiscus, Cochrane, PEDro), which identified 15 studies that were categorized as RT, ET or OITM. The different exercise modalities were reviewed and a meta-analysis evaluating the effect of RT on muscle strength was made. RESULTS: In PD intensive exercise therapy (RT, ET and OITM) is feasible and safe. There is strong evidence that RT can improve muscle strength in PD, which is underlined by the meta-analysis (g' = 0.54 (95% CI 0.22 to 0.86)). There is moderate evidence that ET can improve cardio-respiratory fitness in PD. RT, ET and OITM may have beneficial effects on balance, walking performance, Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score and quality of life in PD, but findings are inconsistent. No studies find deterioration in any outcomes following exercise therapy. CONCLUSION: RT, ET and OITM all represent feasible, safe and beneficial adjunct rehabilitation therapies in PD.
With permission from Excerpta Medica Inc.

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