Objective: To investigate the difference in the effects of aerobic exercise on motor function in patients with Parkinson’s disease (PD) according to exercise intervention protocols.

Background: Although growing evidence suggests that aerobic exercise has beneficial effects on motor symptoms in patients with PD, it remains unclear which specific aerobic exercise regimen optimizes improvement in these symptoms.

Method: Four independent reviewers screened the search results and extracted data from randomized controlled trials of aerobic exercise interventions in PD patients through PubMed, Web of Science, Cochrane Library, and ClinicalTrials (from inception to March 2023). Motor function was assessed using either the Unified PD Rating Scale (UPDRS) III or Movement Disorder Society-UPDRS III as an outcome measure. We employed random effects meta-analysis models, and moderator variable analyses were conducted based on exercise type (aerobic exercise vs. aerobic-based combined exercise), duration (<60 min vs. ≥60 min per session), frequency (<four vs. ≥four numbers of sessions per week), period (<12 weeks vs. ≥12 weeks), and intensity (low-to-moderate vs. moderate-to-high).

Results: Twenty-six randomized controlled trials including 1,325 patients with PD were eligible for this meta-analysis. Aerobic exercise interventions demonstrated significant improvements in overall motor function (P<0.001). In the moderator variable analyses, all categories were significantly effective in improving motor symptoms. However, aerobic-based combined exercise had a greater effect size on motor symptoms compared to aerobic exercise alone (P=0.010). Additionally, ≥60 min per session showed a significantly increased effect size compared to <60 min per session (P=0.012). The impact of aerobic exercise did not differ based on exercise frequency (P=0.418), period (P=0.177), or intensity (P=0.259).

Conclusion: Our observations suggest that exercise type and amount may be more important than intensity in determining the effect of aerobic exercise in patients with PD. However, considering the heterogeneous exercise protocols and effect sizes across the included studies, this possibility requires further investigation through long-term interventional studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/moderators-of-aerobic-exercise-effects-on-motor-symptoms-in-patients-with-parkinsons-disease-a-systematic-review-and-meta-analysis/