Exercise Tied to Reduced Parkinson's Motor Symptoms, Increased Well-being

Eve Bender

March 28, 2023

Physical exercise may improve the motor symptoms and quality of life for patients with Parkinson's disease (PD), new research shows.

A systematic review of 156 clinical trials involving 8000 patients with PD, showed dancing and aquatic exercise, in particular, were most likely to improve motor symptoms, while swimming, endurance training, and mind-body training were most likely to benefit quality of life (QoL).

Moritz Ernst

"For most types of exercise we studied, we observed positive effects on both the severity of motor signs and quality of life. These results highlight the importance of exercise in general, as they suggest people with Parkinson's disease can benefit from a variety of exercises," study investigator Moritz Ernst, MSc, deputy head of the working group on evidence-based medicine at the University Hospital Cologne in Cologne, Germany, told Medscape Medical News.

"Clinicians and people with PD may have several options of exercise programs to choose from when establishing an individual training routine," he added, emphasizing that overall those with PD should seek professional advice, including assessment of motor and nonmotor symptoms, to develop a training agenda based on their individual needs.

The study was published online earlier this year in the Cochrane Database of Systematic Reviews.

May I Have This Dance?

The investigators analyzed data from randomized, controlled trials comparing different types of exercise and no exercise and the subsequent effect on PD symptoms.

Exercise included dance, strength-resistance training, mind-body training such ad tai chi and yoga, water-based training, resistance training, gait/balance/functional training, and endurance training.

The average age of study participants ranged from 60 to 74 years, and most of the studies included patients with mild to moderate PD. The mean length of the various interventions was 12 weeks.

When the researchers examined the effect of exercise on motor symptoms, they found that dance (P = .88), aqua-based training (P = .69), and gait/balance/functional training (P = .67) were most likely to reduce symptom severity.

Aqua-based training (P = .95), endurance training (P = .77), and mind-body training (P = .75) were most were most likely to benefit QoL, although the investigators caution that these findings were at risk of bias because quality of life was self-reported.

The investigators note other study limitations including the fact that most of the studies included in the review had small sample sizes and their study only included patients with mild-to-moderate vs severe PD.

Ernst said that future research should include larger samples, report intent-to-treat analyses, and involve participants with more advanced forms of PD who may also have cognitive difficulties.

Prescribe Exercise

"We should be giving our patients, no matter where they are in their disease stage, a 'prescription' to exercise," Mitra Afshari, MD, MPH, told Medscape Medical News.

Dr Mitra Afshari

Afshari, who was not involved in the study, but leads her own research on PD and exercise as the site principal investigator on the NIH-funded SPARX3 Study in Parkinson's Disease and Exercise at Rush University in Chicago, Illinois, said that based on her experience caring for PD patients at all disease stages noted that "patients who have been physically active their whole lives and can maintain that activity despite their diagnosis fare the best."

However, she added, those who initiate physical exercise after diagnosis can also do very well and reap benefits, including improved motor symptoms.

The study was funded by University Hospital of Cologne, Faculty of Medicine and University Hospital, University of Cologne, Germany, and the German Ministry of Education and Research. The authors have disclosed no relevant financial relationships.

Cochrane Database Syst Rev. Published online January 5, 2023. Abstract

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