Systematic Review
Effect of Resistance Exercise on Body Structure and Function, Activity, and Participation in Individuals With Parkinson Disease: A Systematic Review

https://doi.org/10.1016/j.apmr.2021.01.081Get rights and content

Abstract

Objective

To investigate the effects of resistance exercise (RE) on body structure and function, activity, and participation in individuals with Parkinson Disease (PD) in the mild to moderate stages.

Data Sources

Medline, Embase, Web of Science, The Cochrane Library, Lilacs, and PEDro were searched from inception until June 2020 using the terms “Parkinson Disease,” “Exercise,” “Resistance Training,” “Muscle Strength,” “Cardiorespiratory Fitness,” “Postural Balance,” “Gait,” and “Quality of Life.”

Study Selection

We included studies conducted in individuals with PD involving RE compared with a control group. Two independent reviewers performed the selection process based on titles, abstracts, and full-text reading. In total, 270 individuals with PD were included from 10 selected studies.

Data extraction

Two reviewers independently extracted characteristics related to participants, intervention and control types, and results. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the Grading of Recommendation, Assessment, Development, and Evaluations approach.

Data Synthesis

The level of evidence for body structure and function was low and without effect for lower limb muscle strength; very low and with effect for upper limb muscle strength, cardiorespiratory fitness, and postural balance; and very low and without effect for flexibility after RE training. For activity, the evidence was very low and with effect for gait and very low and without effect for mobility. For participation (ie, quality of life) the evidence was very low and without effect.

Conclusions

Although the level of evidence was low to very low, RE was shown to promote improvements in body structure and function (upper limb muscle strength, cardiovascular function, postural balance) and activity (gait). In contrast, RE did not significantly improve participation (quality of life). However, based on the present findings, the practice of RE can be recommended for individuals with PD in the mild to moderate stages.

Section snippets

Protocol

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines25 and recommendations of the Cochrane Collaboration26 were followed. We appraised the level of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.27

Type of studies

Randomized controlled clinical trials (RCTs) comparing one group undergoing treatment with RE and a control group were considered eligible for the present study.

Participants

Studies involving individuals with a diagnosis of PD in

Description of studies

The electronic search of the databases led to the retrieval of 2833 studies. After the selection defined by consensus, 10 studies were included in the present review,33, 34, 35, 36, 37, 38, 39, 40, 41, 42 involving a total of 270 individuals with PD (137 in the intervention groups, 133 in the control groups). All 10 studies were submitted to the GRADE analysis for the determination of the level of evidence. Details on the selection process with the main reasons for exclusion are displayed in

Discussion

The purpose of the present systematic review was to investigate the effects of RE on body structure and function, activity, and participation in individuals with PD in the mild to moderate stages. The main finding was that RE was shown to improve body structure and function (upper limb muscle strength, cardiorespiratory fitness and postural balance) and activity (gait) in this population. Based on the GRADE approach, the level of synthesized evidence was low to very low. The GRADE approach

Implications for clinical practice

Although the level of evidence was low to very low, RE was shown to promote improvements in body structure and function (upper limb muscle strength, cardiorespiratory fitness, postural balance) and activity (gait). Therefore, the practice of RE can be recommended for individuals with PD in the mild to moderate stages. RE for the lower limbs, upper limbs, and trunk using resistance-training machines, free weights, or therabands from 30-70 minutes (2-4 sets with 4-20 repetitions) 2 times a week

Supplier

  • a.

    State of the Art through Systematic Review; Laboratory of Research on Software Engineering (LaPES).

References (59)

  • A.H.V. Schapira et al.

    Neuroprotection in Parkinson disease: mysteries, myths, and misconceptions

    JAMA

    (2004)
  • T. Pringsheim et al.

    The prevalence of Parkinson's disease: a systematic review and meta-analysis

    Mov Disord

    (2014)
  • L. Hirsch et al.

    The incidence of Parkinson's disease: a systematic review and meta-analysis

    Neuroepidemiology

    (2016)
  • International classification of functioning, disabilities, and health: ICF

    (2001)
  • How to use the ICF: a practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment

    (2013)
  • S.A. Parashos et al.

    Measuring disease progression in early Parkinson disease: the National Institutes of Health Exploratory Trials in Parkinson Disease (NET-PD) experience

    JAMA Neurol

    (2014)
  • M. van Nimwegen et al.

    Physical inactivity in Parkinson's disease

    J Neurol

    (2011)
  • M.E. Morris et al.

    Quantifying the profile and progression of impairments, activity, participation, and quality of life in people with Parkinson disease: protocol for a prospective cohort study

    BMC Geriatr

    (2009)
  • J.A. Opara et al.

    Quality of life in Parkinson`s Disease

    J Med Life

    (2012)
  • S.H. Fox et al.

    The Movement Disorder Society evidence-based medicine review update: treatments for the motor symptoms of Parkinson's disease

    Mov Disord

    (2011)
  • M.A. Hirsch et al.

    Exercise and neuroplasticity in persons living with Parkinson's disease

    Eur J Phys Rehabil Med

    (2009)
  • F.J. David et al.

    Progressive resistance exercise and Parkinson's disease: a review of potential mechanisms

    Parkinsons Dis

    (2012)
  • D.M. Corcos et al.

    A two-year randomized controlled trial of progressive resistance exercise for Parkinson's disease

    Mov Disord

    (2013)
  • T.A. Scandalis et al.

    Resistance training and gait function in patients with Parkinson's disease

    Am J Phys Med Rehabil

    (2001)
  • V.A. Goodwin et al.

    The effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis

    Mov Disord

    (2008)
  • M.M. Hoehn et al.

    Parkinsonism: onset, progression and mortality

    Neurology

    (1967)
  • L. Roeder et al.

    Effects of resistance training on measures of muscular strength in people with Parkinson's disease: a systematic review and meta-analysis

    PLoS One

    (2015)
  • C.L.H. Chung et al.

    Effectiveness of resistance training on muscle strength and physical function in people with Parkinson's disease: a systematic review and meta-analysis

    Clin Rehabil

    (2016)
  • D. Moher et al.

    Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement

    PLoS Med

    (2009)
  • Cited by (13)

    • Effect of aerobic exercise on functional capacity and quality of life in individuals with Parkinson's disease: A systematic review of randomized controlled trials

      2021, Archives of Gerontology and Geriatrics
      Citation Excerpt :

      The level of scientific evidence was analyzed and synthesized using the GRADE approach, which analyzes the following domains: limitations, inconsistency, indirectness, imprecision, and publication bias (Guyatt et al., 2008). This data analysis and synthesis model has been used in previous systematic reviews (Buto et al., 2020; Oliveira, Reis & Pereira, 2021). The electronic search of the databases led to the retrieval of 2788 studies involving a total of 411 individuals with PD: 255 in the intervention groups and 156 in the control groups.

    View all citing articles on Scopus

    Supported by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil (finance code 001).

    Disclosures: none.

    View full text