Effects of Group Exercise on Motor Function and Mobility for Parkinson Disease: A Systematic Review and Meta-Analysis

Abstract

Abstract Objective Parkinson disease is associated with a predictable decline in motor function and mobility that is commonly managed with exercise. There is a limited understanding of the effects of group exercise compared to individual exercise and usual care on motor function and mobility. Our purpose was to investigate the effects of group exercise compared to individual exercise and usual care on motor function and mobility for people with Parkinson disease. Methods A systematic review and meta-analysis was performed with randomized control trials that investigated the effects of group compared with individual exercise and usual care on motor function and mobility for people with Parkinson disease. A systematic search was performed in PubMed, EBSCO, and Science Direct databases. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development and Evaluation approach. Results Twenty-three studies assessed at least 1 mobility-related outcome measure, met our inclusion criteria, and were included in quantitative analysis. There was no significant difference on motor function and mobility between group exercise and individual exercise for all standardized outcome assessment meta-analyses. Motor function and mobility was significantly improved with group exercise compared to usual care in 9 of 11 standardized outcome assessment meta-analyses. Results were based upon low to moderate quality of evidence. Conclusion Based upon low to moderate quality of evidence, group exercise has a similar to larger effect as individual exercise and usual care on improving motor function and mobility for people with Parkinson disease. When used in combination with skilled physical therapy, group exercise may be an appropriate adjunct to individualized physical therapy to maximize mobility and function. Impact Long-term adherence to exercise is essential to maintain mobility and motor function for people with Parkinson disease. Our study suggests group exercise is as effective as individual exercise and may be an appropriate option to encourage long-term adherence related to increased access, socialization, and accountability.