Abstract
Background/Objectives: Aerobic exercise and mind-body exercise, are vital for improving motor and non-motor functional performance of Parkinson’s disease (PD). However, evidence-based recommendations on which type of exercise is most suitable for each individual are still lacking. Therefore, we conduct a network meta-analysis to assess the relative efficacy of aerobic and mind-body exercise on motor function and non-motor symptoms in Parkinson’s disease and to determine which of these therapies are the most suitable.Design: A network meta-analysis and dose-response analysis.Setting and Participants: Medline, Embase (all via Ovid), and the Cochrane Central Register of Controlled Trials were comprehensively searched for related trials through April 2021.Measurements: Study quality was evaluated using the Cochrane Risk of Bias Tool. The effect sizes of continuous outcomes were calculated using mean differences (MDs) or standardized mean differences (SMDs). A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of the therapies. The dose-response relationship was determined based on metaregression and SUCRA.Results: Fifty-two trials with 1971 patients evaluating six different therapies were identified. For the UPDRS-motor score and TUG score, yoga all ranked highest (SUCRA = 92.8%, 92.6%, respectively). The SUCRA indicated that walking may best improve the BBS score (SUCRA = 90.2%). Depression, cognitive and activities of daily living scores were significantly improved by yoga (SUCRA: 86.3, 95.1, and 79.5%, respectively). In the dose-response analysis, 60-min sessions, two times a week might be the most suitable dose of yoga for reducing the UPDRS-motor score of PD patients.Conclusion: Yoga and walking are important options for increasing functional mobility and balance function, and yoga might be particularly effective for decreasing depressive symptoms and cognitive impairment and improving activities of daily living in PD. The potential optimal dose of yoga for enhancing motor ability in PD patients is 60-min sessions, two times a week.Registration: PROSPERO CRD42021224823.
Highlights
According to epidemiological studies of Parkinson’s disease (PD), the global PD population reached approximately 6,100,000 in 2016 (Collaborators, 2018, 2019), making it the second most common neurodegenerative disorder
A total of 52 eligible randomized controlled trials (RCTs) with 1,971 patients diagnosed with PD were included in this network meta-analysis
The results showed that a duration of 60 min was the most suitable duration for reducing the Unified Parkinson’s Disease Rating Scale (UPDRS)-motor score of PD patients (SUCRA: 98.2%, Figures 4B–D)
Summary
According to epidemiological studies of Parkinson’s disease (PD), the global PD population reached approximately 6,100,000 in 2016 (Collaborators, 2018, 2019), making it the second most common neurodegenerative disorder. Previous meta-analyses have demonstrated that these types of exercise may be beneficial for maintaining brain health, promoting functional mobility performance, psychosocial function and quality of life (Shu et al, 2014; Kwok et al, 2016; Chen et al, 2020; Schootemeijer et al, 2020). These types of exercise might exert positive effect on cognitive function and wellbeing by enhancing cerebrovascular angiogenesis and regulating the brain plasticity (da Silva et al, 2018; Mandolesi et al, 2018; Pianta et al, 2019). Systematically determining the most effective treatment options for particular signs and symptoms from among all available types of aerobic exercise and mind-body exercise is critical to providing individual evidence-based recommendations for PD patients
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