Abstract
Parkinson disease (PD) is a chronic neurodegenerative condition that leads to progressive disability. PD-related reductions in muscle strength have been reported to be associated with lower functional performance and balance confidence with an increased risk of falls. Progressive resistance training (PRT) improves strength, balance, and functional abilities. This umbrella review examines the efficacy of PRT regarding muscular strength in PD patients. The PubMed, PEDro, Scopus, and Cochrane Library databases were searched from January 2009 to August 2019 for systematic reviews and meta-analyses conducted in English. The populations included had diagnoses of PD and consisted of males and females aged >18 years old. Outcomes measured were muscle strength and enhanced physical function. Eight papers (six systematic reviews and meta-analyses and two systematic reviews) were considered relevant for qualitative analysis. In six of the eight studies, the reported severity of PD was mild to moderate. Each study analyzed how PRT elicited positive effects on muscle strength in PD patients, suggesting 10 weeks on average of progressive resistance exercises for the upper and lower limbs two to three times per week. However, none of the studies considered the postworkout follow-up, and there was no detailed evidence about the value of PRT in preventing falls. The possibility of PRT exercises being effective for increasing muscle strength in patients with PD, but without comorbidities or severe disability, is discussed. Overall, this review suggests that PRT should be included in rehabilitation programs for PD patients, in combination with balance training for postural control and other types of exercise, in order to preserve cardiorespiratory fitness and improve endurance in daily life activities.
Highlights
Parkinson disease (PD) is a progressive neurodegenerative chronic disease that is characterized by tremor, muscle rigidity, and bradykinesia [1]
The search resulted in 144 records; 135 records were screened on the basis of their titles and abstracts, and one article was rejected because it was not a systematic review [33]
In their systematic review and meta-analysis, Saltychev et al examined whether there was evidence on the effectiveness of Progressive resistance training (PRT) on the spine and lower limb muscles. e authors analyzed 12 randomized controlled trials (RCTs) that studied the effects of PRT on fast and comfortable walking speed, the Timed Up and Go Test, the 6-min walk test, and maximum oxygen consumption. ey found statistical but clinically insignificant results in favor of PRT and concluded that RCTs with larger sample sizes and longer follow-up periods that compared with other types of physical training were needed to make clinical recommendations [27]
Summary
Parkinson disease (PD) is a progressive neurodegenerative chronic disease that is characterized by tremor, muscle rigidity, and bradykinesia [1]. Patients can present with postural instability, leading to an increased risk of falls, social isolation, and a decline in quality of life [2]. PD is characterized by Lewy bodies containing alpha-synuclein and a reduction in dopamine concentrations in the substantia nigra. PD involves dysfunctional cholinergic transmission due to neuronal loss in the nucleus basalis of Meynert and noradrenergic and serotoninergic ascending systems [3]. It is important to emphasize how PD negatively impacts quality of life due to increased motor disability, loss of independence, and social isolation [2]. Due to the greater risk of falls, patients limit their ambulation out of the home [6] and their participation in outdoor activities [7]
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