Rhythmic cueing, dance, resistance training, and Parkinson's disease: A systematic review and meta-analysis

Abstract

ObjectivesThe aim of the present systematic review and meta-analysis was to synthesize evidence associated with the functional and clinical effectiveness of rhythmic cueing, dance, or resistance training (RT) on motor and non-motor parameters in Parkinson's Disease patients, and to provide a comparative perspective not offered by existing systematic reviews.MethodologyEligibility criteria for selecting studies retained no restrictions in methodological design and included interventions of rhythmic cueing, dance, RT, and measurements of motor and non-motor parameters. Animal studies, reviews, editorials, conferences, magazines, and gray literature articles were excluded. Two independent investigators searched Cochrane Library, Medline, PubMed, and SPORTDiscus from the date of their inception until 1 June 2021. The ROBINS-I tool was employed for the non-randomized controlled trials, and the updated for Risk of Bias 2 tool of Cochrane Library used for randomized controlled trials. For meta-analyses, the RevMan 5.4.13 software was used. For incompatible meta-analysis studies, a narrative data synthesis was conducted.ResultsA total of 49 studies included in the systematic review involving 3767 PD participants. Meta-analyses revealed that rhythmic cueing training assists gait velocity (p = 0.01), stride length (p = 0.01), and motor symptoms (p = 0.03). Similarly, dance training benefits stride length (p = 0.05), lower extremity function-TUG (p = 0.01), and motor symptoms (p = 0.01), whilst RT improves lower extremity function-TUG (p = 0.01), quality of life (p = 0.01), knee flexion (p = 0.02), and leg press (p = 0.01). Subgroup analyses have shown non-significant differences in gait velocity (p = 0.26), stride length (p = 0.80), functional mobility-TUG (p = 0.74), motor symptoms-UPDRS-III (p = 0.46), and quality of life-PDQ39 (p = 0.44).ConclusionRhythmic cueing, dance, or RT positively affect the examined outcomes, with rhythmic cueing to be associated with three outcomes (Gait, Stride, and UPDRS-III), dance with three outcomes (TUG, Stride, and UPDRS-III), and RT with two outcomes (TUG and PDQ-39). Subgroup analyses confirmed the beneficial effects of these forms of exercise. Clinicians should entertain the idea of more holistic exercise protocols aiming at improving PD manifestations.International Prospective Register of systematic reviews (PROSPERO) (registration number: CRD42020212380).

Effect of Physiotherapy Interventions on Motor Symptoms in People With Parkinson’s Disease: A Systematic Review and Meta-Analysis

“…Previous studies have shown that strength training and aerobic training play important roles in improving motor function (Carvalho et al, 2015; Zhou et al, 2022). Because strength training builds muscle strength and improves muscle weakness caused by PD (Karpodini et al, 2022) and aerobic exercise improves blood flow and promotes neuroplasticity (Petzinger et al, 2013; Zhou et al, 2022), these effects may play a beneficial role in improving motor function in people with PD. Our study supports the benefits of both physiotherapy treatments in terms of motor symptom severity, but this effect does not achieve clinical improvement.…”

“…When considering the effect of the different intervention types on walking speed, all four intervention types had a positive effect but did not show statistical significance. Previous studies have also reported on the limited effectiveness of strength training, dance, and aerobic exercise in improving walking speed (Karpodini et al, 2022; Radder et al, 2020). However, some reviews have found that Tai Chi and BGT can significantly improve walking speed (Radder et al, 2020; Wu et al, 2022).…”

“…This difference may be due to the limited number of studies included in this study, in which only studies with sham-treated controls were included and studies with controls receiving other active physiotherapy were excluded. Walking endurance, as measured by the 6-MWT, is a more commonly used indicator than walking speed (Karpodini et al, 2022; Radder et al, 2020; Wu et al, 2022). Both mind-body exercise and aerobic exercise have been found to improve aerobic endurance (Winser et al, 2018; Zhen et al, 2022), so it is no surprise that both were found to significantly improve walking endurance in people with PD.…”

“…We found that strength training, BGT and mind-body exercise significantly improved functional mobility, while aerobic exercise and NiBS had no significant effect. Strength training, BGT and mind-body exercises can increase muscle strength in the lower limbs (Karpodini et al, 2022; Wu et al, 2022), and mind-body exercises such as Tai Chi and yoga can also improve flexibility (Wu et al, 2022), all of those can help people with PD perform better on TUG tests. Possibly limited by the number of studies included, aerobic exercise and NiBS did not show effectiveness on functional mobility.…”

The Effects of a Single Session of a Rhythmic Movement Program on Selected Biopsychological Parameters in PD Patients: A Methodological Approach

“…Research in PD has revealed that rhythmic training seems to improve synchronization of neural activity in the brain, especially in the basal ganglia [ 12 ]. A systematic review evaluating the effect of rhythmic auditory stimulation on motor and non-motor parameters in PD patients revealed positive effects on gait parameters and mobility [ 13 ]. Another study revealed that rhythmic movement interventions that incorporate visual and auditory cues can improve sensorimotor integration [ 14 ].…”