Critically appraised paper: Exercise interventions improve some walking-related outcomes in people with Parkinson’s disease [commentary]

摘要

Objective: To review the evidence of whether exercise improves walking- related outcomes in people with Parkinson's disease. Data sources: MEDLINE, CINAHL Plus, PubMed, and SPORTDiscus were searched up to June 2017. Study selection: Randomised controlled trials involving people with Parkinson’s disease, and in which exercise interventions were compared to non-exercise control interventions or another form of exer- cise. Outcome measures were: gait speed (comfortable and fast), stride/ step length, cadence, double-leg support time (percentage of the gait cycle duration), Timed Up and Go test, 6-minute walk test, Freezing of Gait questionnaire, and the Dynamic Gait Index. Data extraction: Two re- viewers extracted data. Methodological quality was assessed using the PEDro Scale, with differences in ratings resolved through discussion. Data synthesis: Of 669 trials initially identified, 40 were included in the meta- analysis, with a total of 1656 participants ranging in Hoehn and Yahr stages I to IV. PEDro scores ranged from 3 to 8 points, indicating low to high methodological quality. The studies evaluated a vast array of exercise in- terventions, including balance training, physiotherapy, resistance training, treadmill and overground gait training, Tai Chi, yoga, boxing, cycling, and aquatic therapy.