BACKGROUND: Exercise therapy is an important component of non-drug treatment for Parkinson's disease (PD). However, the impact of moderate aerobic exercise on PD remains unclear. The purpose of this systematic review was to evaluate the efficacy and safety of moderate aerobic exercise for patients with PD. METHODS: Databases including the Cochrane Library, PubMed, Web of Science, Embase, Chinese Biomedical Literature (CBM) Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and the Weipu Database for Chinese Technical Periodicals (VIP) were searched electronically from the date of inception of the database to June 2020 to recruit relevant randomized controlled trials (RCTs) investigating the efficacy and safety of moderate aerobic exercise on balance and other symptoms in patients with PD. Literature screening, data extraction, and quality evaluation were carried out. RevMan 5.1 (http://ims.cochrane.org/revman) was used for data analysis. RESULTS: In total, nine RCTs with 444 patients were included in this study. Most of the included trials had a low risk of bias and high methodological quality. The meta-analysis suggested that moderate aerobic exercise is effective in improving balance (weighted mean difference (WMD) -0.42, 95% confidence interval (CI) -0.59 to -0.25, p < 0.001) and gait (WMD 49.97, 95% CI 17.84 to 82.10, p < 0.001) in patients with PD, but not in motor symptoms (WMD -2.14, 95% CI -4.86 to 0.58, p = 0.12). Subgroup analysis showed that the improvement in the quality of life of PD patients was affected by different types of exercise, and the treadmill subgroup improved significantly (WMD -3.90, 95% CI -5.02 to -2.78), p < 0.001). CONCLUSIONS: On the whole, moderate aerobic exercise effectively improves balance and gait in patients with PD, but the effect on motor symptoms is not obvious. Different exercise styles have varying effects on the quality of life of PD patients. It is necessary to standardize the exercise program further and carry out indepth research in the future.

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