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| Optimal dose and type of exercise to improve motor symptoms in adults with Parkinson's disease: a network meta-analysis |
| Wang J, Yuan Y, Xie T, Zhang L, Xu H, Lin S-C, Yang Y, Zhu D, Zhuang J |
| Journal of Science and Medicine in Sport 2025 Apr;28(4):282-291 |
| systematic review |
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OBJECTIVES: This study aimed to evaluate the dose-response relationship between different exercise types and the alleviation of motor symptoms in Parkinson's Disease patients. DESIGN: A systematic review and network meta-analysis were conducted to compare the effects of 12 exercise types on motor symptoms in Parkinson's Disease patients using randomized controlled trials. METHODS: A systematic search was conducted across PubMed, Medline, Embase, PsycINFO, Cochrane Library, and Web of Science until September 10, 2024. A total of 81 trials involving 4596 patients were included. Mean differences with 95% credible intervals were calculated, and evidence quality was assessed using Confidence in Network Meta-Analysis. The Minimum Clinically Important Difference was used to assess clinical efficacy. RESULTS: The optimal exercise dose for overall motor symptom improvement was 1300 MET-min/week (mean difference -6.07, 95% credible intervals -8.10 to -4.01). Dance at 850 MET-min/week provided the greatest improvement (mean difference -11.18, 95% credible intervals -16.01 to -6.22). Significant improvements were seen with doses as low as 60 to 100 MET-min/week for body weight support training, dance, resistance training, and sensory exercise. The Minimum Clinically Important Difference was achieved with doses exceeding 670 MET-min/week for overall exercise, and at lower doses for specific types: aerobic exercise (1100 MET-min/week), body weight support (420 MET-min/week), and dance (230 MET-min/week). CONCLUSIONS: The optimal exercise dose for alleviating motor symptoms in Parkinson's Disease patients is 1300 MET-min/week, with dance being most effective at 850 MET-min/week. These findings provide evidence-based recommendations for Parkinson's Disease management.
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