{"title":"Effects of different exercises on improving gait performance in patients with Parkinson's disease: a systematic review and network meta-analysis.","authors":"Ying Li, Jieling Huang, Jinguo Wang, Yue Cheng","doi":"10.3389/fnagi.2025.1496112","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Gait disorder represents a characteristic symptom of Parkinson's disease (PD), and exercise has been established as an effective intervention for gait management in PD. However, the relative efficacy of various exercise types in improving gait among PD patients remains unclear. This study aimed to compare the effectiveness of different movement-based interventions in enhancing gait for individuals with PD through a network meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The methodological quality of included studies was evaluated using the Cochrane Bias risk tool. Data was extracted from these studies to compare the efficacy of 29 distinct exercise interventions on gait performance in patients with PD.</p><p><strong>Results: </strong>The analysis encompassed 68 randomized controlled trials (RCTs), involving a total of 3,114 participants. The results of the network meta-analysis showed that DE is higher than CON (SMD, 2.11; 95% CI 1.07 to 3.15), WE (SMD, 2.16; 95% CI 0.90 to 3.43), HE (SMD, 2.19; 95% CI 0.95 to 3.44), OE (SMD, 2.66; 95% CI 1.16 to 4.16), TR (SMD, 2.62; 95% CI 1.45 to 3.79) to better improve Gait velocity in patients with Parkinson's disease. DE is superior to CON (SMD, 2.08; 95% CI 0.04 to 4.13) in improving Step length. FAE is superior to CON (SMD, 1.01; 95% CI 0.04 to 1.98), BDJ (SMD, 1.20; 95% CI 0.15 to 2.25), RAGT (SMD, 1.29; 95% CI 0.07 to 2.52), DE (SMD, 1.57; 95% CI 0.36 to 2.77), TR (SMD, 1.62; 95% CI 0.48 to 2.76), OE (1.76, 95% CI 0.57 to 2.94) in improving Gait velocity. RAGT is superior to CT (MD, 2.02; 95% CI 0.41 to 3.63), TR (MD, 2.51; 95% CI 1.17 to 3.84), AE (MD, 2.66; 95% CI 0.45 to 4.88), BDJ (MD, 2.77; 95% CI 0.93 to 4.61), CON (MD, 2.83; 95% CI 1.30 to 4.36), DTT (MD, 12.84; 95% CI 10.05 to 15.63) in improving 6MWT.</p><p><strong>Conclusion: </strong>Our study found that DE improved gait speed and step length in patients with Parkinson's disease better than other forms of exercise. FAE and RAGT were more effective than other exercises in improving step length and 6MWT in patients with Parkinson's disease.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1496112"},"PeriodicalIF":4.5000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897016/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Aging Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fnagi.2025.1496112","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Gait disorder represents a characteristic symptom of Parkinson's disease (PD), and exercise has been established as an effective intervention for gait management in PD. However, the relative efficacy of various exercise types in improving gait among PD patients remains unclear. This study aimed to compare the effectiveness of different movement-based interventions in enhancing gait for individuals with PD through a network meta-analysis.
Methods: A comprehensive search was conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The methodological quality of included studies was evaluated using the Cochrane Bias risk tool. Data was extracted from these studies to compare the efficacy of 29 distinct exercise interventions on gait performance in patients with PD.
Results: The analysis encompassed 68 randomized controlled trials (RCTs), involving a total of 3,114 participants. The results of the network meta-analysis showed that DE is higher than CON (SMD, 2.11; 95% CI 1.07 to 3.15), WE (SMD, 2.16; 95% CI 0.90 to 3.43), HE (SMD, 2.19; 95% CI 0.95 to 3.44), OE (SMD, 2.66; 95% CI 1.16 to 4.16), TR (SMD, 2.62; 95% CI 1.45 to 3.79) to better improve Gait velocity in patients with Parkinson's disease. DE is superior to CON (SMD, 2.08; 95% CI 0.04 to 4.13) in improving Step length. FAE is superior to CON (SMD, 1.01; 95% CI 0.04 to 1.98), BDJ (SMD, 1.20; 95% CI 0.15 to 2.25), RAGT (SMD, 1.29; 95% CI 0.07 to 2.52), DE (SMD, 1.57; 95% CI 0.36 to 2.77), TR (SMD, 1.62; 95% CI 0.48 to 2.76), OE (1.76, 95% CI 0.57 to 2.94) in improving Gait velocity. RAGT is superior to CT (MD, 2.02; 95% CI 0.41 to 3.63), TR (MD, 2.51; 95% CI 1.17 to 3.84), AE (MD, 2.66; 95% CI 0.45 to 4.88), BDJ (MD, 2.77; 95% CI 0.93 to 4.61), CON (MD, 2.83; 95% CI 1.30 to 4.36), DTT (MD, 12.84; 95% CI 10.05 to 15.63) in improving 6MWT.
Conclusion: Our study found that DE improved gait speed and step length in patients with Parkinson's disease better than other forms of exercise. FAE and RAGT were more effective than other exercises in improving step length and 6MWT in patients with Parkinson's disease.
期刊介绍：
Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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