Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
J Parkinsons Dis. 2024;14(s1):S115-S133. doi: 10.3233/JPD-230343.
Physical exercise interventions are known to improve quality of life, motor and non-motor symptoms in people with Parkinson's disease (PD). However, systematic reviews and meta-analyses on cognitive outcomes are rare.
To perform a systematic review and meta-analysis of physical exercise intervention effects compared with passive and active control groups (CGs) on global cognition in people with PD.
A literature search was performed for randomized controlled trials (RCTs) on physical exercise interventions in PD using nine databases. We included RCTs reporting global cognition outcomes. A meta-analysis was performed using random-effects models and standardized mean differences (SMDs) with 95% confidence intervals (CIs). Bias was assessed with the revised Cochrane Risk of Bias tool and the certainty of evidence was rated using the GRADE approach.
Seventeen studies (ten with passive, seven with active CGs) were included in the systematic review. Exercise interventions varied considerably between studies. The meta-analysis included nine studies with 236 people with PD (seven with passive, two with active CGs). The SMD was 0.33 (95% CI 0.00; 0.65) demonstrating a small effect (p = 0.05) in favor of physical exercise. Compared with passive CGs, physical exercise had a small non-significant effect (SMD = 0.22, 95% CI -0.14;0.58, p = 0.24). Compared with active CGs, physical exercise had a medium significant effect (SMD = 0.72, 95% CI 0.12;1.33, p = 0.02).
Physical exercise may increase global cognition in people with PD, but the evidence is very uncertain. Further large-scale RCTs are needed to confirm this finding and to identify the most effective type of physical exercise for improving cognition.
运动干预已知可改善帕金森病（PD）患者的生活质量、运动和非运动症状。然而，关于认知结果的系统评价和荟萃分析很少。
对与帕金森病患者的被动和主动对照组（CG）相比，运动干预对整体认知的影响进行系统评价和荟萃分析。
使用九个数据库对 PD 运动干预的随机对照试验（RCT）进行文献检索。我们纳入了报告整体认知结果的 RCT。使用随机效应模型和标准化均数差（SMD）及其 95%置信区间（CI）进行荟萃分析。使用修订后的 Cochrane 偏倚风险工具评估偏倚，并使用 GRADE 方法评估证据的确定性。
17 项研究（10 项为被动 CG，7 项为主动 CG）被纳入系统评价。研究之间的运动干预差异很大。荟萃分析纳入了 9 项研究，共 236 名 PD 患者（7 项为被动 CG，2 项为主动 CG）。SMD 为 0.33（95%CI 0.00；0.65），表明运动干预具有较小的效果（p=0.05）。与被动 CG 相比，运动干预具有较小但无统计学意义的效果（SMD=0.22，95%CI-0.14；0.58，p=0.24）。与主动 CG 相比，运动干预具有中等显著效果（SMD=0.72，95%CI 0.12；1.33，p=0.02）。
运动可能会增加 PD 患者的整体认知，但证据非常不确定。需要进一步的大规模 RCT 来证实这一发现，并确定改善认知最有效的运动类型。
