Parkinson's disease (PD) is a progressive
neurological disorder characterized by motor and non-motor symptoms for which only
symptomatic treatments
exist. Exercise is a widely studied complementary treatment option.
Aerobic exercise, defined as continuous movement of the body's large
muscles in a rhythmic manner for a sustained period that increases
caloric requirements and aims at maintaining or improving physical
fitness, appears promising. We performed both a scoping review and a
systematic review
on the generic and disease-specific health benefits of aerobic exercise
for people with PD. We support this by a meta-analysis on the effects
on physical fitness (VO
2max), motor symptoms (Movement Disorder Society
Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor section), and health-related
quality of life (39-item
Parkinson's disease
Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits
for people with PD, including a reduced incidence of cardiovascular
disease, a lower mortality, and an improved bone health. Additionally,
there is level 1 evidence that aerobic exercise improves physical
fitness (VO
2max) and attenuates motor symptoms
(MDS-UPDRS motor section) in the off-medication state, although the
long-term effects (beyond 6 months) remain unclear. Dosing the exercise
matters: improvements appear to be greater after training at higher
intensities compared with moderate intensities. We found insufficient
evidence for a beneficial effect of aerobic exercise on health-related
quality of life (PDQ-39) and conflicting results regarding non-motor
symptoms. Compliance to exercise regimes is challenging for PD patients
but may be improved by adding exergaming elements to the training
program. Aerobic exercise seems a safe intervention for people with PD,
although care must be taken to avoid falls in at-risk individuals.
Further studies are needed to establish the long term of aerobic
exercise, including a focus on non-motor symptoms and health-related
quality of life.
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