Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials

Introduction Parkinson’s disease is a movement disorder that also manifests non-motor symptoms (NMS). Physical exercise is a prominent strategy that can have an impact on NMS; however, the evidence is limited. Our aim was to verify the effects of exercise on NMS, as assessed using general NMS scales...

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Main Authors: Valton Costa, Alice de Oliveira Barreto Suassuna, Thanielle Souza Silva Brito, Thalita Frigo da Rocha, Anna Carolyna Gianlorenco
Format: Article
Language:English
Published: BMJ Publishing Group 2023-10-01
Series:BMJ Neurology Open
Online Access:https://neurologyopen.bmj.com/content/5/2/e000469.full
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author Valton Costa
Alice de Oliveira Barreto Suassuna
Thanielle Souza Silva Brito
Thalita Frigo da Rocha
Anna Carolyna Gianlorenco
author_facet Valton Costa
Alice de Oliveira Barreto Suassuna
Thanielle Souza Silva Brito
Thalita Frigo da Rocha
Anna Carolyna Gianlorenco
author_sort Valton Costa
collection DOAJ
description Introduction Parkinson’s disease is a movement disorder that also manifests non-motor symptoms (NMS). Physical exercise is a prominent strategy that can have an impact on NMS; however, the evidence is limited. Our aim was to verify the effects of exercise on NMS, as assessed using general NMS scales.Methods This study is a systematic review and meta-analysis. Two searches were conducted on the PubMed, Cochrane Library, Scopus, Web of Science, Embase, Science Direct and PEDro databases from September to December 2022. The PEDro scale was used to assess the methodological quality of the studies.Results Twenty-three studies were included. The interventions were classified as multimodal, aerobic, resistance, dance, conventional physical therapy and other types. Five studies had high risk of bias. Eight studies were included in the meta-analyses. According to the criteria, four studies compared exercise with non-exercise (n=159), two compared multimodal exercise with cognitive/leisure approaches (n=128), and two compared aerobic with conventional exercise (n=40). No statistical differences were observed between exercise and non-exercise (−0.26 (−0.58 to 0.05)) and between multimodal and cognitive approaches (0.21 (−0.14 to 0.55)). However, trends were observed in the direction of exercise and cognitive approaches. A significant difference was observed favouring aerobic over conventional exercise (−0.72 (−1.36 to −0.08)).Conclusions Our findings suggest that exercise may have an effect on general NMS compared with non-exercise, although only a trend was observed. It was also observed for cognitive approaches over multimodal exercises. Aerobic exercise showed near-large effects compared with conventional exercise.
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spelling doaj-art-306aeab634e44a3fbcd97e8a9a4cbb0e2025-08-20T02:54:27ZengBMJ Publishing GroupBMJ Neurology Open2632-61402023-10-015210.1136/bmjno-2023-000469Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trialsValton Costa0Alice de Oliveira Barreto Suassuna1Thanielle Souza Silva Brito2Thalita Frigo da Rocha3Anna Carolyna Gianlorenco4Neurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, BrazilDepartment of Electrical Engineering, Centre for Innovation and Technology Assessment in Health, Federal University of Uberlandia, Uberlandia, BrazilNeurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, BrazilNeurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, BrazilNeurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Sao Paulo, BrazilIntroduction Parkinson’s disease is a movement disorder that also manifests non-motor symptoms (NMS). Physical exercise is a prominent strategy that can have an impact on NMS; however, the evidence is limited. Our aim was to verify the effects of exercise on NMS, as assessed using general NMS scales.Methods This study is a systematic review and meta-analysis. Two searches were conducted on the PubMed, Cochrane Library, Scopus, Web of Science, Embase, Science Direct and PEDro databases from September to December 2022. The PEDro scale was used to assess the methodological quality of the studies.Results Twenty-three studies were included. The interventions were classified as multimodal, aerobic, resistance, dance, conventional physical therapy and other types. Five studies had high risk of bias. Eight studies were included in the meta-analyses. According to the criteria, four studies compared exercise with non-exercise (n=159), two compared multimodal exercise with cognitive/leisure approaches (n=128), and two compared aerobic with conventional exercise (n=40). No statistical differences were observed between exercise and non-exercise (−0.26 (−0.58 to 0.05)) and between multimodal and cognitive approaches (0.21 (−0.14 to 0.55)). However, trends were observed in the direction of exercise and cognitive approaches. A significant difference was observed favouring aerobic over conventional exercise (−0.72 (−1.36 to −0.08)).Conclusions Our findings suggest that exercise may have an effect on general NMS compared with non-exercise, although only a trend was observed. It was also observed for cognitive approaches over multimodal exercises. Aerobic exercise showed near-large effects compared with conventional exercise.https://neurologyopen.bmj.com/content/5/2/e000469.full
spellingShingle Valton Costa
Alice de Oliveira Barreto Suassuna
Thanielle Souza Silva Brito
Thalita Frigo da Rocha
Anna Carolyna Gianlorenco
Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
BMJ Neurology Open
title Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
title_full Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
title_fullStr Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
title_full_unstemmed Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
title_short Physical exercise for treating non-motor symptoms assessed by general Parkinson’s disease scales: systematic review and meta-analysis of clinical trials
title_sort physical exercise for treating non motor symptoms assessed by general parkinson s disease scales systematic review and meta analysis of clinical trials
url https://neurologyopen.bmj.com/content/5/2/e000469.full
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