Objective: To compare the efficacy and safety of physical interventions for people with Parkinson’s disease (PD).

Background: Physical interventions are effective in managing PD, but the relative benefit of different exercise types remains unclear.

Method: A systematic review of randomized controlled trials (RCTs) on physical interventions for PD was conducted. We analyzed the effects of different physical interventions on motor functions and quality of life (QoL) using network meta-analyses (NMAs). We evaluated the study quality and rated our confidence in the evidence. Effects on adverse events (AEs) were summarized narratively.

Results: We included 156 RCTs. The NMA on motor functions and QoL included data from 71 (n=3196), and 55 (n=3283) trials, respectively. The number of participants per trial arm was small (M=20.7, range: 4-115).
Risk of bias was high for most study results (motor functions: 71%; QoL: 100% due to self-report).
We found beneficial effects on motor functions for most physical interventions compared to a passive control group (moderate: dance [high confidence], aqua-based, gait-balance-functional, and multi-domain trainings [low confidence]; small: mind-body, and endurance trainings [low confidence]). We observed beneficial effects on QoL that were large for aqua-based trainings [moderate confidence], moderate for endurance trainings [low confidence], and small for gait-balance-functional, and multi-domain trainings [low confidence].
A large proportion of high-risk-of-bias-studies and wide prediction intervals were the most common limitations to our confidence in the effects.
Only 85 studies provided safety data and conducting an NMA was not possible due to heterogeneous reporting. No or no serious AEs occurred in 44 studies. Relatively mild AEs occurred in 28 studies. The most frequently reported AEs were falls and pain.

Conclusion: We found evidence of beneficial effects on motor functions and QoL for most physical interventions for people with PD, but very little evidence of differences between these interventions. Thus, our review highlights the importance of physical interventions, while the exact exercise type might be secondary. Accordingly, it seems that any movement counts for people with PD. The interventions included in our review were relatively safe. Larger, well-conducted studies are needed to increase the confidence in the evidence.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-key-is-any-movement-results-from-a-cochrane-systematic-review-and-network-meta-analysis-on-physical-interventions-for-parkinsons-disease/