Background: Parkinson’s disease (PD) is a neurodegenerative disorder with increasing prevalence into older age. PD is associated with motor and non-motor symptoms, which affect quality of life (QoL), ability to perform activities of daily living, and functional independence. Aerobic exercise (AE) is the most commonly prescribed exercise modality in PD, although optimal type, frequency, and duration are undefined. This umbrella review aimed to summarise and synthesize existent evidence regarding the effectiveness of AE on balance, gait, functional mobility, and QoL in PD patients.
Methods: Six databases: Pubmed/MEDLINE, PEDro, Scopus, Cochrane Library, Embase, and CINAHL, were searched for systematic reviews reporting the effects of AE on balance, gait, functional mobility, and QoL in PD patients from inception to June 2024. Searches and data extraction were conducted by two independent reviewers. Methodological quality of evidence was assessed using the AMSTAR-2 tool.
Results: 4182 records were initially identified, with 17 systematic reviews included in this umbrella review for qualitative analysis. Included reviews were conducted between 2014 and 2023. The majority of included reviews (n=12) were rated as critically low for methodological quality, with four rated as low and one as high. Moderate intensity was the most commonly investigated AE intensity (n=4), although almost half of the included systematic reviews (n=8) did not report intensity. The AE protocols ranged from 1 to 7 days each week, and from 1 to 64 weeks in duration. Session length was between 20 and 120 minutes. Reported outcomes included gait (n=15 reviews), QoL (n=14), balance (n=12), and functional mobility (n=7). The findings of this review highlight that AE does improve aspects of gait, balance, and functional mobility in PD patients. However, it does not appear to improve QoL.
Conclusions: AE is recommended as part of rehabilitation programmes for people with PD. However, research exploring the efficacy of AE on physiological and psychological parameters assesses multiple modalities with substantial variation in the quantity of exercise prescribed. Further research, preferably high-quality randomised controlled trials, is needed to identify specific AE training protocols that will best alleviate the symptoms of PD, providing an evidence base for effective clinical translation.