Effect of Proprioceptive Training Compared With Other Interventions for Upper Limb Deficits in People With Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

ObjectiveThis systematic review and meta-analysis aimed to determine the efficacy of proprioceptive training on hand dexterity, upper limb function, and quality of life (QoL) in people with Parkinson disease (PD) compared with no or other active interventions. Data SourcesMedline PubMed, Cochrane Library, CINAHL, PEDro, and Web of Science databases were searched to identify published studies until February 2023. Study SelectionPeer-reviewed English publications of randomized controlled trials (RCTs) of proprioceptive training conducted among people with PD. Data ExtractionStudy characteristics, exercise program type and dosage, outcome of interest, and between-group comparisons of post-test results of intervention and comparison groups. Data SynthesisEight RCTs were included, involving 344 people with PD. Six RCTs contributed to meta-analyses. There was very low certainty of evidence that proprioceptive training may improve dominant hand (standard mean difference [SMD] 0.34, 95% CI 0.08-0.60, P=.01) and non-dominant hand (SMD 0.36, 95% CI 0.10-0.63, P<.01) fine motor dexterity, and dominant hand gross manual dexterity (SMD 1.73, 95% CI 0.30-3.16, P=.02), following 2-8 weeks of proprioceptive training. There was no evidence of effects on non-dominant hand gross manual dexterity, upper limb function, and QoL after proprioceptive training. ConclusionsFindings regarding the effect of proprioceptive training on hand dexterity in the short-term are inconclusive. The small sample size likely limited effect detection. Future large RCTs should compare proprioceptive training with no intervention and perform comprehensive biomechanical analysis to gain a clearer idea of its effects. Incorporating longer-duration proprioceptive training programs is also recommended to investigate long-lasting effects.