Freezing of gait (FOG) in Parkinson’s disease (PD) causes severe patient burden despite pharmacological management. Exercise and training are therefore advocated as important adjunct therapies. In this meta-analysis, we assess the existing evidence for such interventions to reduce FOG, and further examine which type of training helps the restoration of gait function in particular. The primary meta-analysis across 41 studies and 1838 patients revealed a favorable moderate effect size (ES = −0.37) of various training modalities for reducing subjective FOG-severity (p < 0.00001), though several interventions were not directly aimed at FOG and some included non-freezers. However, exercise and training also proved beneficial in a secondary analysis on freezers only (ES = −0.32, p = 0.007). We further revealed that dedicated training aimed at reducing FOG episodes (ES = −0.24) or ameliorating the underlying correlates of FOG (ES = −0.40) was moderately effective (p < 0.01), while generic exercises were not (ES = −0.14, p = 0.12). Relevantly, no retention effects were seen after cessation of training (ES = −0.08, p = 0.36). This review thereby supports the implementation of targeted training as a treatment for FOG with the need for long-term engagement.

尽管进行了药物治疗，帕金森病 (PD) 中的冻结步态 (FOG) 仍会导致严重的患者负担。因此，运动和训练被认为是重要的辅助疗法。在这项荟萃分析中，我们评估了此类干预措施的现有证据，以减少 FOG，并进一步研究哪种类型的训练特别有助于步态功能的恢复。对 41 项研究和 1838 名患者进行的主要荟萃分析显示，各种训练方式对于降低主观 FOG 严重程度具有良好的中等效应大小 (ES = -0.37) ( p < 0.00001)，尽管一些干预措施并不直接针对 FOG，而且有些干预措施并不直接针对 FOG。包括非冷冻柜。然而，在仅对冷冻机进行的二次分析中，运动和训练也被证明是有益的（ES = -0.32， p = 0.007）。我们进一步发现，旨在减少 FOG 发作 (ES = -0.24) 或改善 FOG 潜在相关性 (ES = -0.40) 的专门训练具有中等效果 ( p < 0.01)，而一般练习则不然 (ES = -0.14， p = 0.12）。相关地，停止训练后没有观察到保留效应（ES = -0.08， p = 0.36）。因此，本次审查支持实施有针对性的培训，作为需要长期参与的 FOG 治疗方法。