Effect of Long-term Exercise Therapy on Motor Symptoms in Parkinson Disease Patients A Systematic Review and Meta-analysis of Randomized Controlled Trials

Objectives The aims of the study were to assess the effectiveness of long-term exercise therapy (>= 12 wks) for patients with Parkinson disease and to derive specific suggestions on how the motor symptom improvements can be optimized by exercise type and exercise dose. Design The PubMed, Web of Science, Cochrane Central Register, Embase, Scopus, and CNKI databases were searched up to January 2021 for randomized controlled trials focusing on the effects of long-term exercise for Parkinson disease. Two researchers independently evaluated the quality of papers using the PEDro scale. Twenty-six studies with a total of 1243 participants were included. Results Tai Chi, resistance training, and dance provide significant improvements in physical function and functional mobility. Furthermore, Tai Chi and dance result in balance benefits. However, walking capacity outcomes did not improve after Tai Chi and resistance training but did improve after dance. With an increase in the intervention duration or length of each session, the effect sizes of exercise on these outcomes increased; higher benefits of exercise on these outcomes were observed at a frequency of 2 times/wk. Conclusions Long-term exercise therapy is an effective treatment for improving motor symptoms, with dance being an ideal exercise choice. To Claim CME Credits Complete the self-assessment activity and evaluation online at CME Objectives Upon completion of this article, the reader should be able to: (1) Recognize that long-term exercise slows clinical progression of motor symptoms in patients with Parkinson disease; (2) Acquire knowledge regarding the effectiveness of long-term exercise therapy on motor symptoms in Parkinson disease; and (3) Incorporate specific suggestions on dose-response relationships of different exercise therapy on motor symptoms in Parkinson disease. Level Advanced Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)(TM). Physicians should only claim credit commensurate with the extent of their participation in the activity.