Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis

Abstract

Objectives: To systematically review the evidence investigating the effectiveness of resistance training on strength and physical function in people with Parkinson's disease. Data sources: Seven electronic databases (COCHRANE, CINAHL, Medline ISI, Psycinfo, Scopus, Web of Science ISI and Embase) were systematically searched for full-text articles published in English between 1946 and November 2014 using relevant search terms. Review methods: Only randomized controlled trials investigating the effects of resistance training on muscle strength and physical function in people with Parkinson's disease were considered. The PEDro scale was used to assess study quality. Studies with similar outcomes were pooled by calculating standardized mean differences (SMD) using fixed or random effects model, depending on study heterogeneity. Results: Seven studies, comprising of 401 participants with early to advanced disease (Hoehn & Yahr stage 1 to 4), were included. The median quality score was 6/10. The meta-analyses demonstrated significant SMD in favour of resistance training compared to non-resistance training or no intervention controls for muscle strength (0.61; 95% CI, 0.35 to 0.87; P <0.001), balance (0.36; 95% CI, 0.08 to 0.64; P = 0.01) and parkinsonian motor symptoms (0.48; 95% CI, 0.21 to 0.75; P < 0.001) but not for gait, balance confidence and quality of life. Conclusion: This review demonstrates that moderate intensity progressive resistance training, 2-3 times per week over 8-10 weeks can result in significant strength, balance and motor symptoms gains in people with early to moderate Parkinson's disease.

Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms: A Randomized Clinical Trial

“…A synthesis of previous data is consistent with a physical fitness effect. Treadmill [6][7][8], CYC [9,10], and seated resistance training [11], with a low or no specificity to the temporal and spatial dynamics of standing and walking postures and balance, all improved PD patients' mobility and balance as well or even more effectively than did balance, Tai Chi, dance, yoga, and walking training [3]. As in the present experiment, the patients in these studies were physically untrained and high-intensity and high-frequency exercise is particularly effective in improving motor performance [2].…”

“…Exercises not specific to patients' mobility dysfunction can also improve PD patients' mobility by a functionally meaningful margin. For example, exercise therapy using a treadmill [5][6][7][8], stationary cycling (CYC) [9,10], and seated resistance training [11] with a low specificity for the temporal and spatial dynamics of standing and walking balance all improved PD patients' mobility, postural control, and balance. As demonstrated by a small effect size of 0.4 in a meta-analysis [3], the evidence is unclear with regard to the superiority of any specific exercise program in improving PD patients' mobility and balance.…”

Quality improvement in neurology: Parkinson disease update quality measurement set

“…In addition, the recommendation for rehabilitation has been maintained as there is growing evidence that rehabilitative therapies, physical, speech, and occupational, are effective in improving motor impairment, activities of daily living, and quality of life in PD throughout all stages. [20][21][22][23] There remains clear gaps in care in relation to rehabilitative referrals. 11 Finally, queries regarding medication were maintained as well, which is of great importance as the treatment regimens become increasingly complex.…”

“…Recent evidence suggests that exercise has multiple important health benefits that should be leveraged by patients with PD. Exercise improves the physical and mental functioning levels and quality of life for patients with PD, [22][23][24][25][26] and early intervention with exercise can prevent falls. 26 It should be recommended to all patients with PD.…”

A Comparison of Activity Monitor Data from Devices Worn on the Wrist and the Waist in People with Parkinson's Disease

“…Exercise is widely known to bring health benefits in the general population and in people with chronic neurological conditions, such as Parkinson's disease (PD) . Besides improvements in general health, exercise has been found to reduce falls and improve mobility, balance, and muscle strength in people with PD . Conversely, inactivity increases the risk of developing several health conditions and contributes to premature mortality and is considered a public health issue in the general population.…”