Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: −0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: −0.43, 95% CI = −0.79 to −0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.

步态障碍和不平衡是帕金森病 (PD) 的主要症状，跌倒是最不良的后果。然而，很少有有效的循证治疗可用于缓解这些症状和预防跌倒。胆碱酯酶抑制剂 (ChEIs) 是一种行之有效的 PD 痴呆治疗方法，可能会影响步态、平衡和跌倒减少。本研究涉及随机对照试验 (RCT) 的荟萃分析，以研究 ChEIs 对 PD 患者步态、平衡和跌倒的影响。我们使用 PubMed、Embase 和 Web of Science 数据库搜索了研究。主要结果是对步态参数、平衡和跌倒的影响。本研究已在 PROSPERO (CRD42021254733) 注册。本荟萃分析中包括五项随机对照试验。p  = 0.29）。然而，ChEI 治疗显着降低了单一任务期间的步数或步幅变异性（标准 MD：-0.43，95% CI = -0.79 至 -0.06，p  = 0.02）。关于跌倒和平衡，使用 ChEI 治疗观察到有趋势但不显着的有益效果。总之，虽然 ChEI 治疗没有显着提高步态速度和减少跌倒，但它可以显着减少步幅或步幅的可变性。考虑到步态障碍在 PD 患者中是一个具有挑战性的问题，并且 ChEIs 通常是可以耐受的，本荟萃分析可能会提供更多证据证明 ChEIs 作为替代治疗考虑对 PD 步态障碍有益。