Lorenzo-García Patricia, Núñez de Arenas-Arroyo Sergio, Cavero-Redondo Iván, Guzmán-Pavón María José, Priego-Jiménez Susana, Álvarez-Bueno Celia
Health and Social Research Center, Universidad de Castilla La Mancha, Cuenca, Spain (P.L.-G., S.N.d.A.-A., C.Á.-B.); Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile (I.C.-R.) Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay (C.Á.-B.); Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain (M.J.G.-P.); and Hospital Virgen de la Luz, Hermandad de Donantes de Sangre, Cuenca, Spain (S.P.-J.).
J Neurol Phys Ther. 2023 Apr 1;47(2):64-74. doi: 10.1097/NPT.0000000000000414. Epub 2022 Oct 18.
Physical exercise is considered an effective intervention for maintaining or improving quality of life (QoL) in patients with Parkinson disease (PD), but there is no evidence showing which type of physical exercise intervention has more positive effects. This systematic review and meta-analysis aimed to synthesize the evidence regarding the effectiveness of exercise interventions on improving QoL in patients with PD, comparing different types of exercise interventions.
A literature search was conducted through January 2022. The methodological quality of the trials was assessed using the Cochrane risk of bias tool RoB2. For the meta-analysis, physical exercise interventions were classified into 5 training categories: resistance, endurance, alternative exercises, dance, and sensorimotor interventions. A standard meta-analysis and network meta-analysis were carried out to evaluate the efficacy of the different types of physical exercise interventions.
The search retrieved 2451 studies, 48 of which were included in this network meta-analysis with a total of 2977 patients with PD. The indirect effects of the network meta-analysis showed positive results for alternative exercises (-0.46; 95% confidence interval [CI]: -0.76, -0.16), dance (-0.63; 95% CI: -1.08, -0.17), and sensorimotor interventions (-0.23; 95% CI: -0.40, -0.07) versus control comparisons.
More research is needed to determine the types of physical exercise interventions that are most beneficial and for which conditions of the disease they have the most positive effects.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A398 ).
体育锻炼被认为是维持或改善帕金森病（PD）患者生活质量（QoL）的有效干预措施，但尚无证据表明哪种体育锻炼干预具有更积极的效果。本系统评价和荟萃分析旨在综合关于运动干预对改善PD患者QoL有效性的证据，比较不同类型的运动干预。
检索截至2022年1月的文献。使用Cochrane偏倚风险工具RoB2评估试验的方法学质量。对于荟萃分析，体育锻炼干预分为5种训练类别：阻力训练、耐力训练、替代运动、舞蹈和感觉运动干预。进行标准荟萃分析和网状荟萃分析以评估不同类型体育锻炼干预的疗效。
检索到2451项研究，其中48项纳入本网状荟萃分析，共2977例PD患者。网状荟萃分析的间接效应显示，与对照比较，替代运动（-0.46；95%置信区间[CI]：-0.76，-0.16）、舞蹈（-0.63；95%CI：-1.08，-0.17）和感觉运动干预（-0.23；95%CI：-0.40，-0.07）有积极结果。
需要更多研究来确定最有益的体育锻炼干预类型以及它们对疾病的哪些状况具有最积极的影响。可查看视频摘要以获取作者更多见解（见视频，补充数字内容1，http://links.lww.com/JNPT/A398 ）。
