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Yan Y, Xu Y, Wang X, Wang Y, Huang C, Lin R, Chen M, Lin M, Li H. The effect of multi-component exercise intervention in older people with Parkinson's disease and mild cognitive impairment: A randomized controlled study. Geriatr Nurs 2024; 60:137-145. [PMID: 39244799 DOI: 10.1016/j.gerinurse.2024.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/28/2024] [Accepted: 08/19/2024] [Indexed: 09/10/2024]
Abstract
A multimodal exercise training program might be the best way to improve motor and cognitive function in patients with Parkinson's disease (PD), but this has yet to be fully proven in PD patients with mild cognitive impairment (MCI). This study aims to examine the feasibility and effectiveness of a theory-based, multi-component exercise intervention in older people with PD-MCI. Participants were randomized into an intervention group (n=23) and an active control group (n=23), receiving the theory-based multi-component exercise intervention and Parkinson's health exercises, respectively. All participants performed 60-minute exercise training sessions three times a week over a 12-week period. The retention rate at post-intervention was 95.7% (42/46) for the entire cohort. The attendance rates were 99.6% in the intervention group and 99.5% in the control group. No adverse events occurred. The intervention group showed significantly greater improvements than the control group in global cognitive function, executive function, physical motor function, balance and gait, depression, and quality of life. This study indicates that the theory-based multi-component exercise intervention demonstrates high feasibility in promoting exercise adherence and is an effective treatment option for older adults with PD-MCI.
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Affiliation(s)
- Yuanjiao Yan
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yifei Xu
- The School of Nursing, Fujian Medical University, Fuzhou, China; Jiangsu Province Disabled Persons' Assistive Devices Service Center, Nanjing, China
| | - Xiaoxia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China; College of Optical and Electronic Technology, China Jiliang University, Hangzhou, China
| | - Yunxian Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China; Department of nursing, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Chenshan Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Mingfeng Chen
- Neurology Department, Fujian Provincial Hospital, Fuzhou, China
| | - Mojun Lin
- The School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Nogueira Haas A, Smith T, Peyré-Tartaruga LA, Brito Fortes M, Nagy F, Dos Santos Delabary M, Koutedakis Y, Wyon M. Can Dance Improve Turning in People With Parkinson's Disease? J Dance Med Sci 2024; 28:179-189. [PMID: 38587104 DOI: 10.1177/1089313x241242632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To investigate the effects of a dance intervention on selected functional parameters during the 180° turning phase of the Timed Up & Go (TUG) test in people with Parkinson's Disease (PwPD). Methods: Fifteen adults clinically diagnosed with idiopathic PD were allocated into dance intervention (DIG; n = 7 ; age 73 ± 2 years) and control (CG; n = 8; age 64 ± 5 years) groups. The dance intervention lasted for 3 months (1 hour, twice a week). At baseline, all participants completed the Unified PD Rating Scale-part III, the International Physical Activity Questionnaire-short form, and the Hoehn & Yahr scale. Pre- and post-intervention, the primary outcomes were measured (number of steps and time to complete the 180° turning phase of the TUG test) at 2 speeds (comfortable walking and as quickly and safely speed) while using the Xsens® 3D motion suit. The secondary outcome (girdle dissociation) was assessed by calculating the difference between pelvis and affected shoulder orientation in the transverse plane (dissociation angles) at each data point during the TUG test's 180° turning phase. Results: At participant's comfortable walking speed, the functionality during the 180° turning remained unaffected following the dance intervention. However, at participant's fast speed, the dance intervention group significantly reduced the number of steps with a large effect size, and the total time taken to complete the 180° turning with a medium effect size. Post-intervention, most participants in the dance intervention group reduced the affected shoulder and pelvic girdle dissociation and turned more "en bloc." Conclusion: Dance can improve selected functional parameters during the 180° turning at fast speed in PwPD. The current results should be considered in rehabilitation programs.
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Affiliation(s)
- Aline Nogueira Haas
- Department of Physical Education, Physiotherapy and Dance Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
- Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Tina Smith
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
| | - Leonardo Alexandre Peyré-Tartaruga
- Department of Physical Education, Physiotherapy and Dance Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marlene Brito Fortes
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
| | - Fruzsina Nagy
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
| | - Marcela Dos Santos Delabary
- Department of Physical Education, Physiotherapy and Dance Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Yiannis Koutedakis
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
- Department of Sport and Exercise Sciences, University of Thessaly, Trikala, Greece
| | - Matthew Wyon
- Sport and Physical Activity Research Centre and School of Performing Arts, University of Wolverhampton, Walsall, UK
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Rice PE, Thumuluri D, Barnstaple R, Fanning J, Laurita-Spanglet J, Soriano CT, Hugenschmidt CE. Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework. J Alzheimers Dis 2024:JAD230741. [PMID: 39031353 DOI: 10.3233/jad-230741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging. Objective To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations. Methods Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life). Results High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified. Conclusions Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.
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Affiliation(s)
- Paige E Rice
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Deepthi Thumuluri
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Christina T Soriano
- Department of Theatre and Dance, Wake Forest University, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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States RA, Dewan B, Lynam P, Mensah N, Pottorf O. Group exercise for balance in people with Parkinson's disease: a systematic review with meta-analysis. Physiother Theory Pract 2024:1-18. [PMID: 38975875 DOI: 10.1080/09593985.2024.2374063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND High-quality evidence shows that exercise helps people with Parkinson's disease improve functional abilities including balance. However, few studies have investigated whether the setting and format through which balance-focused exercise programs are provided matters. This systematic review investigated group exercise compared to individual exercise, and to no-exercise control (CTL), on clinical measures of balance for people with Parkinson's disease. METHODS MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL databases were searched through March 24, 2024, on terms for Parkinson's disease; exercise or physical activity; community-based or group classes; balance or postural control. Citations, abstracts and full-text articles were independently reviewed, and included studies were rated on risk of bias by two authors. RESULTS Twenty-seven randomized controlled trials (30 reports) with 1200 participants met criteria. Meta-analysis using mean difference (MD) compared group exercise to CTL on seven clinical measures of balance. Three yielded significant differences favoring group exercise: Timed Up and Go = -2.29 (MD), -3.56 to -1.02 (95% Confidence interval) (95% CI); Mini-BEST = 2.72 (MD), 1.88 to 3.57 (95% CI); Berg Balance Scale = 4.31 (MD), 1.33 to 7.29 (95% CI). Meta-analyses were also conducted on six clinical measures of balance, comparing group exercise to individual exercise, yielding no significant differences. CONCLUSIONS For people with Parkinson's disease, group exercise may be more effective than CTL on some clinical measures of balance and it yields similar results to individual exercise. People with Parkinson's disease are encouraged to participate regularly in group or individual exercise based on preference and accessibility.
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Affiliation(s)
- Rebecca A States
- Doctor of Physical Therapy Program, Hofstra University, Hempstead, NY, USA
| | - Birendra Dewan
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | - Peggy Lynam
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | - Nia Mensah
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | - Ofra Pottorf
- Doctor of Physical Therapy Program, Hofstra University, Hempstead, NY, USA
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Rabini G, Meli C, Prodomi G, Speranza C, Anzini F, Funghi G, Pierotti E, Saviola F, Fumagalli GG, Di Giacopo R, Malaguti MC, Jovicich J, Dodich A, Papagno C, Turella L. Tango and physiotherapy interventions in Parkinson's disease: a pilot study on efficacy outcomes on motor and cognitive skills. Sci Rep 2024; 14:11855. [PMID: 38789492 PMCID: PMC11126665 DOI: 10.1038/s41598-024-62786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Pharmacological treatments in Parkinson's disease (PD), albeit effective in alleviating many motor symptoms, have limited effects in non-motor signatures as cognitive impairment, as well as in other aspects included postural instability. Consequently, complementary interventions are nowadays a prerogative of clinical practice managing PD symptomatology. In this pilot longitudinal study, we recruited twenty-four PD patients participating in one of two interventions: adapted Argentine Tango or group-based physiotherapy. Participants underwent a motor and neuropsychological evaluation before and after four months of activities, carried out twice a week. We found a general stabilization of motor and cognitive abilities, with significant improvements in several motor skills, mainly pertaining to static and dynamic balance, similarly in both groups. At cognitive level, we measured a significant improvement in both groups in the Action Naming task. Interestingly, only PD patients in the Tango group improved their performance in the test measuring facial emotion recognition. These findings highlight the crucial role that physical activities have in the stabilization and slowdown of disease's progression in PD. They further highlight the beneficial effects of a group-based physical intervention, which, especially in the case of Tango, could lead to behavioral ameliorations in domains other than the motor, such as emotion recognition.
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Affiliation(s)
- Giuseppe Rabini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Prodomi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Chiara Speranza
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Federica Anzini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Enrica Pierotti
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giorgio Giulio Fumagalli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Raffaella Di Giacopo
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Maria Chiara Malaguti
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Luca Turella
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
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Cheng WH, Quan Y, Thompson WF. The effect of dance on mental health and quality of life of people with Parkinson's disease: A systematic review and three-level meta-analysis. Arch Gerontol Geriatr 2024; 120:105326. [PMID: 38237379 DOI: 10.1016/j.archger.2024.105326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Parkinson's disease (PD) is a neurodegenerative disease that affects millions of individuals worldwide. Dance has emerged as a comprehensive intervention for enhancing well-being in this population. This meta-analysis aimed to assess the effectiveness of dance on mental health and quality of life among individuals with PD. METHODS Three databases were searched in December 2022. Research papers comparing the effects of dance with a non-dance control on the quality of life or mental health of individuals with PD were included. Two authors independently screened the studies, extracted data, and assessed methodological quality of eligible studies. To address the interdependence of effect sizes within studies, the three-level meta-analysis approach was employed to analyze the data. RESULTS Thirteen trials involving a total of 496 participants were included, with 11 being subjected to statistical analysis. The results indicated that dance had a positive impact on mental health (g = 0.43, 95 % CI = [0.11, 0.75]) and quality of life (g = 0.46, 95 % CI = [-0.04, 0.95]) when compared to passive control groups. Moderator analyses revealed that non-partnered dance and dance interventions with lower total dosages were particularly beneficial for mental health. CONCLUSION Dance interventions are an effective lifestyle activity for enhancing mental health and quality of life in individuals with PD. A theoretical framework is proposed to explain the impact of dance on well-being from neurological, social, physical, and psychological perspectives.
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Affiliation(s)
- Wei-Hsin Cheng
- Faculty of Society and Design, Bond University, Queensland 4229, Australia
| | - Yixue Quan
- School of Psychological Sciences, Macquarie University, Sydney 2109, Australia
| | - William Forde Thompson
- Faculty of Society and Design, Bond University, Queensland 4229, Australia; School of Psychological Sciences, Macquarie University, Sydney 2109, Australia.
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Zhang Y, Liu S, Xu K, Zhou Y, Shen Y, Liu Z, Bai Y, Wang S. Non-pharmacological therapies for treating non-motor symptoms in patients with Parkinson's disease: a systematic review and meta-analysis. Front Aging Neurosci 2024; 16:1363115. [PMID: 38737585 PMCID: PMC11082280 DOI: 10.3389/fnagi.2024.1363115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/18/2024] [Indexed: 05/14/2024] Open
Abstract
Objective The non-motor symptoms of Parkinson's disease (PD) are an important part of PD. In recent years, more and more non-drug interventions have been applied to alleviate the non-motor symptoms of PD, but the relevant evidence is limited. This systematic review and meta-analysis was designed to evaluate the efficacy of non-drug interventions in patients with non-motor symptoms in patients with PD. Methods Seven databases, including Pubmed, Embease, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database (WANFANG), VIP database (VIP), and China Biomedical Literature Service System (CBM) were searched from the establishment of the database to December 2023. Non-drug interventions such as acupuncture, cognitive behavioral therapy (CBT), exercise, repetitive transcranial magnetic stimulation (rTMS), and non-motor symptoms of Parkinson's disease were selected as search words, and two independent evaluators evaluated the included literature's bias risk and data extraction. The therapeutic efficacy was evaluated by the Parkinson's Disease Sleep Scale (PDSS), Hamilton Depression Scale (HAMD), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), Minimum Mental State Examination (MMSE), and Parkinson's Disease Questionnaire-39 (PDQ-39). RevMan 5.4.1 (Reviewer Manager Software 5.4.1). Cochrane Collaboration, Oxford, United Kingdom analyzed the data and estimated the average effect and the 95% confidence interval (CI). A heterogeneity test is used to assess differences in the efficacy of different non-drug treatments. Results We selected 36 from 4,027 articles to participate in this meta-analysis, involving 2,158 participants. Our combined results show that: PDSS: [mean difference (MD) = -19.35, 95% CI (-30.4 to -8.28), p < 0.0006]; HAMD: [MD = -2.98, 95% CI (-4.29 to -1.67), p < 0.00001]; BDI: [MD = -2.69, 95% CI (-4.24 to 4.80), p = 0.006]; HAMA: [MD = -2.00, 95% CI (-2.83 to -1.17), p < 0.00001]; MMSE: [MD = 1.20, 95% CI (0.71 to 1.68), p < 0.00001]; CoMA: [MD = 2.10, 95% CI (-0.97 to 3.23), p = 0.0003]; PDQ-39: [MD = -4.03, 95% CI (-5.96 to -1.57), p < 0.00001]. Conclusion The four non-drug measures used in our review showed significant improvements in sleep, depression, anxiety, cognition, constipation, and quality of life compared with the control group, and no serious adverse events were reported in the included research evidence, and we found that there were some differences among the subgroups of different intervention methods, but due to the less literature included in the subgroup, and the comparison was more indirect. So, we should interpret these results carefully. Systematic review registration www.crd.york.ac.uk/PROSPERO, identifier CRD42023486897.
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Affiliation(s)
- Yu Zhang
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Shuang Liu
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Ke Xu
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Yan Zhou
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Yiwei Shen
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Zhengnan Liu
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Yan Bai
- Institute of Acupuncture and Moxibustion, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Shun Wang
- School of Acupuncture-Moxibustion and Tuina, Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Institute of Acupuncture and Moxibustion, Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
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Maher S, Donlon E, Mullane G, Walsh R, Lynch T, Fearon C. Treatment of Apathy in Parkinson's Disease and Implications for Underlying Pathophysiology. J Clin Med 2024; 13:2216. [PMID: 38673489 PMCID: PMC11051068 DOI: 10.3390/jcm13082216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Apathy is a prevalent and highly debilitating non-motor symptom of Parkinson's disease (PD) that is often overlooked in clinical practice due to its subtle nature. This review aims to provide a comprehensive overview of the current evidence for the treatment of apathy in PD, highlighting recent advancements and emerging therapeutic avenues. In this review, we analyse a diverse array of treatment strategies for apathy in PD, including pharmacological interventions, non-pharmacological approaches, and emerging neuromodulation techniques. We evaluate the efficacy, safety, and limitations of established pharmacotherapies, such as dopaminergic agents, antidepressants, and cognitive enhancers. Additionally, we examine the promising role of non-pharmacological interventions, encompassing psychotherapies and behavioural interventions, in ameliorating apathetic symptoms. Furthermore, this review explores the effects of neuromodulation techniques on apathy, including the modulation of apathy via deep brain stimulation and emerging data on the potential influence of transcranial magnetic stimulation (TMS) on apathy in PD. Ultimately, a deeper understanding of effective treatment strategies for apathy has the potential to significantly improve the quality of life and overall well-being of individuals living with PD.
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Affiliation(s)
- Senan Maher
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Eoghan Donlon
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Gerard Mullane
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
| | - Richard Walsh
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- Academic Unit of Neurology, School of Medicine, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Tim Lynch
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Conor Fearon
- Dublin Neurological Institute, Mater Misericordiae Hospital, D07 W7XF Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
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9
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Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2024; 4:CD013856. [PMID: 38588457 PMCID: PMC11001292 DOI: 10.1002/14651858.cd013856.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear. OBJECTIVES To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs). SEARCH METHODS An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. MAIN RESULTS We included 154 RCTs with a total of 7837 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 60 (2721 participants), and 48 (3029 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson's Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (60 studies; 2721 participants) suggests that dance and gait/balance/functional training probably have a moderate beneficial effect on the severity of motor signs (dance: mean difference (MD) -10.18, 95% confidence interval (CI) -14.87 to -5.36; gait/balance/functional training: MD -7.50, 95% CI -11.39 to -3.48; moderate confidence), and multi-domain training probably has a small beneficial effect on the severity of motor signs (MD -5.90, 95% CI -9.11 to -2.68; moderate confidence). The evidence also suggests that endurance, aqua-based, strength/resistance, and mind-body training might have a small beneficial effect on the severity of motor signs (endurance training: MD -5.76, 95% CI -9.78 to -1.74; aqua-based training: MD -5.09, 95% CI -10.45 to 0.40; strength/resistance training: MD -4.96, 95% CI -9.51 to -0.40; mind-body training: MD -3.62, 95% CI -7.24 to 0.00; low confidence). The evidence is very uncertain about the effects of "Lee Silverman Voice training BIG" (LSVT BIG) and flexibility training on the severity of motor signs (LSVT BIG: MD -6.70, 95% CI -16.48 to 3.08; flexibility training: MD 4.20, 95% CI -1.61 to 9.92; very low confidence). Quality of life The evidence from the NMA (48 studies; 3029 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -15.15, 95% CI -23.43 to -6.87; moderate confidence). The evidence also suggests that mind-body, gait/balance/functional, and multi-domain training and dance might have a small beneficial effect on QoL (mind-body training: MD -7.22, 95% CI -13.57 to -0.70; gait/balance/functional training: MD -6.17, 95% CI -10.75 to -1.59; multi-domain training: MD -5.29, 95% CI -9.51 to -1.06; dance: MD -3.88, 95% CI -10.92 to 3.00; low confidence). The evidence is very uncertain about the effects of gaming, strength/resistance, endurance, and flexibility training on QoL (gaming: MD -8.99, 95% CI -23.43 to 5.46; strength/resistance training: MD -6.70, 95% CI -12.86 to -0.35; endurance training: MD -6.52, 95% CI -13.74 to 0.88; flexibility training: MD 1.94, 95% CI -10.40 to 14.27; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types. AUTHORS' CONCLUSIONS We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD.
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Affiliation(s)
- Moritz Ernst
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Lieker
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Caro-Valenzuela
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Cryns
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Resarch, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Ambulatory Assessment in Psychology, Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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10
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Palm D, Swarowsky A, Gullickson M, Shilling H, Wolden M. Effects of Group Exercise on Motor Function and Mobility for Parkinson Disease: A Systematic Review and Meta-Analysis. Phys Ther 2024; 104:pzae014. [PMID: 38335243 DOI: 10.1093/ptj/pzae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/22/2023] [Accepted: 11/30/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Parkinson disease (PD) is associated with a predictable decline in motor function and mobility that is commonly managed with exercise. There is a limited understanding of the effects of group exercise compared to individual exercise (IE) and usual care (UC) on motor function and mobility. Our purpose was to investigate the effects of group exercise compared to IE and UC on motor function and mobility for people with PD. METHODS A systematic review and meta-analysis was performed with randomized control trials that investigated the effects of group compared with IE and UC on motor function and mobility for people with PD. A systematic search was performed in PubMed, EBSCO, and Science Direct databases. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS Twenty-three studies assessed at least 1 mobility-related outcome measure, met our inclusion criteria, and were included in quantitative analysis. There was no significant difference on motor function and mobility between group exercise and IE for all standardized outcome assessment meta-analyses. Motor function and mobility were significantly improved with group exercise compared to UC in 9 of 11 standardized outcome assessment meta-analyses. Results were based upon low to moderate quality of evidence. CONCLUSION Based upon low to moderate quality of evidence, group exercise has a similar to larger effect as IE and UC on improving motor function and mobility for people with PD. When used in combination with skilled physical therapy, group exercise may be an appropriate adjunct to individualized physical therapy to maximize mobility and function. IMPACT Long-term adherence to exercise is essential to maintain mobility and motor function for people with PD. Our study suggests group exercise is as effective as IE and may be an appropriate option to encourage long-term adherence related to increased access, socialization, and accountability.
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Affiliation(s)
- Diana Palm
- Physical Therapy Program, University of Jamestown, Fargo, North Dakota, USA
| | | | | | - Holly Shilling
- Physical Therapy Program, University of Jamestown, Fargo, North Dakota, USA
| | - Mitch Wolden
- Physical Therapy Program, University of Jamestown, Fargo, North Dakota, USA
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11
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Costa V, Prati JM, de Oliveira Barreto Suassuna A, Souza Silva Brito T, Frigo da Rocha T, Gianlorenço AC. Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis. J Geriatr Psychiatry Neurol 2024:8919887241237223. [PMID: 38445606 DOI: 10.1177/08919887241237223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD. METHODS Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate. RESULTS Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety. CONCLUSION Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.
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Affiliation(s)
- Valton Costa
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - José Mario Prati
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Alice de Oliveira Barreto Suassuna
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Federal University of Uberlandia, Uberlandia, Brazil
| | - Thanielle Souza Silva Brito
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Thalita Frigo da Rocha
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Anna Carolyna Gianlorenço
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
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12
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Haas AN, Delabary MDS, Passos-Monteiro E, Wolffenbuttel M, Donida RG, Casal MZ, Zanardi APJ, Rodrigues LP, Martinez FG, Peyré-Tartaruga LA. The effects of Brazilian dance, deep-water exercise and nordic walking, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD. Arch Gerontol Geriatr 2024; 118:105285. [PMID: 38056105 DOI: 10.1016/j.archger.2023.105285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Motor and non-motor symptoms affect functional autonomy, mobility and daily life activities in People with Parkinson's Disease (PwPD). Brazilian Dance (BD), Deep-water exercise (DWE), and Nordic Walking (NW) are well-accepted, low-cost, and safe non-pharmacological strategies for untrained PwPD. However, no previous studies have investigated and compared the effects of these interventions on trained PwPD. OBJECTIVE To describe and compare the effects of BD, DWE and NW, pre- and post-12 weeks, on functional-motor and non-motor symptoms in trained PwPD. METHODS Eighty-three trained PwPD were randomly assigned into three groups: BD (n = 31), DWE (n = 21) and NW (n = 31), that participated in one of the interventions for 12 weeks. We applied Timed up and go at two speeds (self-selected and fast); 6-min and 10-meter walk test; Sit-to-Stand and handgrip test; Unified Parkinson Disease Rating Scale - III; Falls Efficacy Scale; Montreal Cognitive Assessment questionnaire; and Parkinson's Disease Questionnaire-39. The main (group and time) and interaction effects were analyzed using GEE analysis (p<0.05). RESULTS Statistical differences were found between groups in the handgrip test (p<0.01), the time (p = 0.04), and interaction group*time (p< 0.01) in the Sit-to-stand test. While BD improved the Sit-to-stand test performance (ES=1.00; large effect size), DWE and NW remained unchanged (ES=0.16 and ES=0.14; low effect size). CONCLUSION BD, DWE, and NW maintained most of the functional-motor and non-motor symptoms in trained PwPD. BD was shown to be more effective at improving strength in the lower limbs, when compared to NW and DWE.
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Affiliation(s)
- Aline Nogueira Haas
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Trinity College Dublin, Global Brain Health Institute, Dublin, Ireland.
| | - Marcela Dos Santos Delabary
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Elren Passos-Monteiro
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Department of Physical Education, School of Physical Education, Federal University of Pará, Castanhal, Pará, Brazil
| | - Mariana Wolffenbuttel
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rebeca Gimenes Donida
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marcela Zimmermann Casal
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Paula Janner Zanardi
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciano Palmeiro Rodrigues
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Flávia Gomes Martinez
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- Department of Physical Education, School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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13
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Huang X, Dong K, Gan C, Xu Z, Lei D, Dong X, Liu H, Chen X. Effect of Rhythmically Cued Exercise Interventions on Functions in Patients With Parkinson Disease: A Meta-Analysis. Phys Ther 2024; 104:pzad158. [PMID: 37962936 DOI: 10.1093/ptj/pzad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease. METHODS PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203). RESULTS A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups. CONCLUSION Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation. IMPACT This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
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Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu Gan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xinghua Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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14
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Mai AS, Lee YS, Yong JH, Teo DCYJ, Wan YM, Tan EK. Treatment of apathy in Parkinson's disease: A bayesian network meta-analysis of randomised controlled trials. Heliyon 2024; 10:e26107. [PMID: 38440294 PMCID: PMC10909723 DOI: 10.1016/j.heliyon.2024.e26107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 01/12/2024] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Background Apathy is an important but unrecognised aspect of Parkinson's disease (PD). The optimal therapeutic options for apathy remain unclear. Early recognition and treatment of apathy can reduce the significant burden of disease for patients and their caregivers. Here we conducted a meta-analysis to evaluate the comparative efficacy of different treatment modalities of apathy in PD (CRD42021292099). Methods We screened Medline, Embase, and PsycINFO databases for articles on therapies for apathy in PD. The outcome of interest is the reduction in apathy scores post-intervention and is measured by standardised mean differences (SMD) with 95% credible intervals (CrI). We included only randomised controlled trials examining interventions targeted at reducing apathy. Results Nineteen studies involving 2372 patients were included in the quantitative analysis. The network meta-analysis found pharmacotherapy to be the most efficacious treatment, significantly better than brain stimulation (SMD -0.43, 95% CrI -0.78 to -0.07), exercise-based interventions (SMD -0.66, 95% CrI -1.25 to -0.08), supplements (SMD -0.33, 95% CrI -0.67 to 0), and placebo (SMD -0.38, 95% CrI -0.56 to -0.23). Subgroup analysis of pharmacotherapy versus placebo found similar efficacy of dopamine agonists (SMD -0.36, 95% CI -0.59 to -0.12, P = 0.003) and alternative medications (SMD -0.42, 95% CI -0.61 to -0.23, P < 0.001). The remaining comparisons and subgroup analyses did not demonstrate any significant treatment effects. Conclusion Our meta-analysis of randomised controlled trials showed that pharmacotherapy is the most efficacious treatment option, with dopamine agonists having similar efficacy as other medications. Further research is needed to determine the optimal management strategy.
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Affiliation(s)
- Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi Siang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jung Hahn Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Yi-Min Wan
- Department of Psychiatry, Ng Teng Fong General Hospital, Singapore
| | - Eng-King Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
- Neuroscience and Behavioural Programme, Duke-NUS Medical School, Singapore
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15
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Hodgson P, Jordan A, Sinani C, Charura D, Orange ST. The relationship between physical function and psychological symptoms in Parkinson's disease: A systematic review and meta-regression analysis. CNS Neurosci Ther 2024; 30:e14562. [PMID: 38334239 PMCID: PMC10853949 DOI: 10.1111/cns.14562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/21/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024] Open
Abstract
AIMS This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any relationships exist between these measures in individuals with Parkinson's disease. METHODS MEDLINE, CINAHL, AMED, and APA PsychInfo databases were systematically searched. Screening, quality assessment, and data extraction were completed alongside meta-regression analysis. RESULTS Of 1175 studies retrieved, 40 were selected for analysis with only one study assessing the relationship between physical and psychological outcomes within their cohort. A total of 27 studies were also eligible for meta-regression analysis-a total sample of 1211 participants. Meta-regressions of five combinations of paired physical and psychological outcomes showed a significant moderating effect of symptoms of depression (Beck Depression Inventory) on mobility (Timed-Up-and-Go test; coefficient = 0.37, 95% CI 0.09 to 0.65, p = 0.012) and balance (Berg Balance Score) scores (coefficient = -1.25, 95% CI -1.77 to -0.73, p < 0.001). CONCLUSION Although physical and psychological outcomes of interest were used in all included studies, only one examined their relationship. Our analysis suggests that symptoms of depression may influence measures of mobility and balance. Specifically, as the severity of symptoms of depression increases, performance on measures of mobility and balance worsens.
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Affiliation(s)
- Philip Hodgson
- Tees, Esk and Wear Valleys NHS Foundation TrustYork St John UniversityYorkUK
- York St John UniversityYorkUK
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16
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Prudente TP, Mezaiko E, Silveira EA, Nogueira TE. Effect of Dancing Interventions on Depression and Anxiety Symptoms in Older Adults: A Systematic Review and Meta-Analysis. Behav Sci (Basel) 2024; 14:43. [PMID: 38247695 PMCID: PMC10813489 DOI: 10.3390/bs14010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/24/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
This systematic review and meta-analysis (PROSPERO CRD42023428105) investigated the effect of dancing on depression and anxiety symptoms in older adults. Conducted up to October 2023, the search across seven databases and gray literature yielded 5020 records. Only randomized trials that analyzed dance interventions for depression and/or anxiety in older adults were included. Nineteen randomized trials, involving 508 participants in dance classes lasting 5 weeks to 18 months, were included and 16 were subjected to meta-analysis. Risk of bias was assessed using the Cochrane tool. The meta-analysis showed a statistically significant reduction in depression among older adults participating in dance interventions (p < 0.01). A decrease in depressive symptoms was significant compared to that in those involved in no other intervention (p = 0.02) but not compared to that achieved with other interventions in control groups (p = 0.96). Subgroup analysis showed no significant differences in depression scores for those with mild cognitive impairment (p = 0.47). These conclusions are associated with moderate bias and very low certainty. Due to heterogeneity and the small number of studies, conclusions for anxiety outcomes could not be drawn. These results underscore the potential clinical relevance of integrating dance into mental health interventions for older adults, thereby highlighting a promising avenue for enhancing the mental well-being of this demographic.
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Affiliation(s)
- Tiago Paiva Prudente
- Faculty of Medicine, Federal University of Goiás (UFG), Goiânia 74605-050, Brazil; (T.P.P.); (E.A.S.)
| | - Eleazar Mezaiko
- Faculty of Dentistry, Federal University of Goiás (UFG), Goiânia 74605-020, Brazil;
| | - Erika Aparecida Silveira
- Faculty of Medicine, Federal University of Goiás (UFG), Goiânia 74605-050, Brazil; (T.P.P.); (E.A.S.)
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17
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Li H, Cao C, Li Y. Self-directed physical activity interventions for motor symptoms and quality of life in early and mid-stage Parkinson's disease: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 116:105159. [PMID: 37625216 DOI: 10.1016/j.archger.2023.105159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Self-directed physical activity (SDPA) has been found in previous research to alleviate some of the symptoms of early and mid-stage Parkinson's disease (PD) patients. So, this study aimed to determine the impact of SDPA on these patients in the areas of motor symptoms, and quality of life (QoL). METHOD PubMed, Embase, the Cochrane Library, the Web of Science, Scopus, and ProQuest were all searched. The risk-of-bias tool of Cochrane for randomized trials, Version 2 (RoB 2), was also used to assess the credibility of studies in terms of their procedures. RESULTS 15 eligible studies were analyzed. SDPA improved motor function and mobility, including timed up and go (TUG) test [standardized mean difference (SMD), -0.55 (95% CI, -0.91 - -0.18), p = 0.003], 6-minute walking (6MW) test [1.11 (0.75 - 1.47), p < 0.00001], stride length [0.45 (0.18 - 0.72), p = 0.001], gait velocity [0.42 (0.04 - 0.81 p = 0.03], Unified Parkinson's Disease Rating Scale Part-III (UPDRS-III) [-0.76 (-1.18 - -0.33), p = 0.0005] and enhanced Berg Balance Scale (BBS) [0.88 (0.50 - 1.27), p < 0.00001]). Despite engaging in SDPA, there was no significant improvement observed in freezing of gait (FOG) [0.23 (-0.11 - 0.56), p = 0.18] as well as the Parkinson's Disease Questionnaire-39 (PDQ-39) [0.04 (-0.55 - 0.62), p = 0.90]). CONCLUSION The motor symptoms of those with early to mid-stage PD improved with SDPA, however the research found no enhancement in FOG or QoL.
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Affiliation(s)
- Hanzhang Li
- Hubei University of Chinese Medicine, Wuhan, China
| | - Chunhao Cao
- Department of Integrated Traditional Chinese and Western Medicine, The First Affiliate Hospital of Chongqing Medical University, Chongqing, China
| | - Yanan Li
- Hubei University of Chinese Medicine, Wuhan, China.
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Folkerts AK, Ernst M, Gollan R, Cryns N, Monsef I, Skoetz N, Kalbe E. Can Physical Exercise Be Considered as a Promising Enhancer of Global Cognition in People with Parkinson's Disease? Results of a Systematic Review and Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S115-S133. [PMID: 38457150 PMCID: PMC11380223 DOI: 10.3233/jpd-230343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Background Physical exercise interventions are known to improve quality of life, motor and non-motor symptoms in people with Parkinson's disease (PD). However, systematic reviews and meta-analyses on cognitive outcomes are rare. Objective To perform a systematic review and meta-analysis of physical exercise intervention effects compared with passive and active control groups (CGs) on global cognition in people with PD. Methods A literature search was performed for randomized controlled trials (RCTs) on physical exercise interventions in PD using nine databases. We included RCTs reporting global cognition outcomes. A meta-analysis was performed using random-effects models and standardized mean differences (SMDs) with 95% confidence intervals (CIs). Bias was assessed with the revised Cochrane Risk of Bias tool and the certainty of evidence was rated using the GRADE approach. Results Seventeen studies (ten with passive, seven with active CGs) were included in the systematic review. Exercise interventions varied considerably between studies. The meta-analysis included nine studies with 236 people with PD (seven with passive, two with active CGs). The SMD was 0.33 (95% CI 0.00; 0.65) demonstrating a small effect (p = 0.05) in favor of physical exercise. Compared with passive CGs, physical exercise had a small non-significant effect (SMD = 0.22, 95% CI -0.14;0.58, p = 0.24). Compared with active CGs, physical exercise had a medium significant effect (SMD = 0.72, 95% CI 0.12;1.33, p = 0.02). Conclusions Physical exercise may increase global cognition in people with PD, but the evidence is very uncertain. Further large-scale RCTs are needed to confirm this finding and to identify the most effective type of physical exercise for improving cognition.
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Affiliation(s)
- Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Moritz Ernst
- Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC, Australia
| | - Nora Cryns
- Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Institute of Public Health, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Jiang C, Luo Y, Qu Y, Wang C, Li Z, Zhou J, Xu Z. Pharmacological and Behavioral Interventions for Fatigue in Parkinson's Disease: A Meta-Analysis of Randomized Controlled Trials. J Geriatr Psychiatry Neurol 2023; 36:487-495. [PMID: 36917786 DOI: 10.1177/08919887231163291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE This study aims to evaluate pharmacological and behavioral interventions for the treatment of fatigue in Parkinson's disease (PD) patients. METHODS We systematically searched PubMed, PsycINFO, Web of Science, EMBASE, CNKI, Wan fang, and VIP up to July 31, 2022. We used Revman 5.3 software for the meta-analysis. The outcomes included Fatigue Severity Scale (FSS) and Parkinson's Fatigue Scale (PFS). The mean difference (MD) and 95% confidence intervals (CI) were collected or calculated. RESULTS Thirteen randomized controlled trials (RCTs) with a total of 1758 patients were included. The meta-analysis showed that current clinical treatments reduced FSS (MD: -1.60, 95% CI: -3.14 to -0.05) and PFS (MD: -0.61, 95% CI: -1.17 to -0.05) in patients with PD. Subgroup meta-analysis showed that: (1) neither pharmacological interventions nor behavioral interventions reduced FSS in PD patients; (2) dopaminergic drugs dose-dependently significantly reduced the PFS in patients with PD; (3) behavioral interventions have an almost significant effect (MD: -6.69, 95% CI: -13.71 to 0.33, P = 0.06, I2 = 74%) on alleviating PFS in PD patients; (4) vestibular rehabilitation training significantly reduced the PFS in patients with PD. CONCLUSIONS Current clinical treatments alleviate fatigue in PD patients. Dopaminergic drugs may act a stronger effect than amphetamines. Behavioral interventions, especially vestibular rehabilitation training, may be a promising way for the treatment of fatigue in patients with PD though further evidence is still needed.
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Affiliation(s)
- Chenke Jiang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yijun Luo
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yiqian Qu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Che Wang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhan Li
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jia Zhou
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhenghao Xu
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou, China
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Langbroek-Amersfoort A, Schootemeijer S, Bouten L, Bloem BR, De Vries NM. Exercise Made Accessible: the Merits of Community-Based Programs for Persons with Parkinson's Disease. Curr Neurol Neurosci Rep 2023; 23:695-715. [PMID: 37792207 PMCID: PMC10673991 DOI: 10.1007/s11910-023-01303-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE OF REVIEW Many studies have identified positive effects of physiotherapy and exercise for persons with Parkinson's disease (PD). Most work has thus far focused on the therapeutic modality of exercise as used within physiotherapy programs. Stimulated by these positive findings, there is now a strong move to take exercise out of the clinical setting and to deliver the interventions in the community. Although the goals and effects of many such community-based exercise programs overlap with those of physiotherapy, it has also become more clear that both exercise modalities also differ in various ways. Here, we aim to comprehensively review the evidence for community-based exercise in PD. RECENT FINDINGS Many different types of community-based exercise for people with PD are emerging and they are increasingly being studied. There is a great heterogeneity considering the types of exercise, study designs, and outcome measures used in research on this subject. While this review is positive regarding the feasibility and potential effects of community-based exercise, it is also evident that the general quality of these studies needs improvement. By focusing on community-based exercise, we hope to generate more knowledge on the effects of a wide range of different exercise modalities that can be beneficial for people with PD. This knowledge may help people with PD to select the type and setting of exercise activity that matches best with their personal abilities and preferences. As such, these insights will contribute to an improved self-management of PD.
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Affiliation(s)
- Anneli Langbroek-Amersfoort
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sabine Schootemeijer
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lars Bouten
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nienke M De Vries
- Center of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.
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21
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He S, Fang W, Wu J, Lv H, Zhang J, Wang T, Huang Y, Li G, Li M. Whether mindfulness-guided therapy can be a new direction for the rehabilitation of patients with Parkinson's disease: a network meta-analysis of non-pharmacological alternative motor-/sensory-based interventions. Front Psychol 2023; 14:1162574. [PMID: 37780170 PMCID: PMC10540073 DOI: 10.3389/fpsyg.2023.1162574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/20/2023] [Indexed: 10/03/2023] Open
Abstract
Background The treatment for Parkinson's disease (PD) consumes a lot of manpower and financial resources. Non-pharmacological alternative motor-/sensory-based interventions are optimized for the rehabilitation of PD patients. Mindfulness-based therapy shows ideal efficacy, but the diversity of the therapy brings difficulties to the selection of clinicians and patients. Methods Network meta-analysis in the Bayesian framework was used to evaluate the efficacy of non-pharmacological alternative motor-/sensory-based interventions in improving motor and non-motor symptoms in PD patients. Results A total of 58 studies (2,227 patients) were included. Compared with the non-intervention group, qigong was associated with improved outcomes in the Timed Up and Go (TUG) test (mean difference (MD) -5.54, 95% confidence interval (CI) -8.28 to -2.77), and UPDRS-I (MD -15.50, 95% CI -19.93 to -7.63). Differences between non-pharmacological alternative motor-/sensory-based interventions were not significant for PDQ-39, UPDRS-I, or UPDRS-II; however, qigong was superior to dance (MD -3.91, 95% CI -6.90 to -0.95), Tai Chi (MD -3.54, 95% CI -6.53 to -0.69), acupuncture (MD -6.75, 95% CI -10.86 to -2.70), music (MD -3.91, 95% CI -7.49 to -0.48), and exercise (MD -3.91, 95% CI -6.49 to -1.33) in the TUG test. Conclusion This network meta-analysis supports mindfulness-based therapy (e.g., qigong, yoga, and Tai Chi) as a preferred non-pharmacological alternative motor-/sensory-based intervention for PD rehabilitation. Systematic review registration https://inplasy.com/inplasy-2022-10-0109/, INPLASY2022100109.
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Affiliation(s)
- Shenglan He
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wanyi Fang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiaoyang Wu
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hang Lv
- The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jueyu Zhang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital (Fifth Clinical Medical College of Guangzhou University of Chinese Medicine), Guangzhou, China
| | - Tunyi Wang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingjie Huang
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guangyao Li
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min Li
- Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
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Rittiwong T, Reangsing C, Schneider JK. The Effects of Dance Interventions on Depression in Older Adults: A Meta-Analysis. J Appl Gerontol 2023; 42:2009-2024. [PMID: 37126730 DOI: 10.1177/07334648231172357] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Meta-analyses of the effects of dance on depressive symptoms in older adults have shown contradictory results, but few primary studies were included (5 and 8 studies). We aimed to examine the effects of dance on depressive symptoms in older adults aged 60 years and older and to examine the moderator effects of the source, participants, methods, and intervention characteristics. We included 23 primary studies that compared depressive symptoms across dance and comparison/control groups of older adults (72 ± 6.7 years old) and were written in English (N = 1,398) participants. Dance groups showed significantly less depressive symptoms post-intervention than comparison groups (ES = 0.66, 95% CI [0.42, 0.91], p < .001, I2 = 76.80%). South America and Australia showed the greatest effects. Using quasi-experimental designs showed significant effect sizes compared to using randomized designs. Only one quality indicator, intention-to-treat, influenced effect size. Dance might be used as an alternative treatment to improve depression.
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Affiliation(s)
- Tanapa Rittiwong
- Faculty of Nursing, Praboromarajchanok Institute, Bangkok, Thailand
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23
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Aldana-Benítez D, Caicedo-Pareja MJ, Sánchez DP, Ordoñez-Mora LT. Dance as a neurorehabilitation strategy: A systematic review. J Bodyw Mov Ther 2023; 35:348-363. [PMID: 37330793 DOI: 10.1016/j.jbmt.2023.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This systematic review aimed to demonstrate the benefits of dance-based therapeutic interventions in rehabilitation processes in patients with neurological disorders. METHODS Searches on the following databases and electronic search engines were conducted: MEDLINE, LILACS, Science Direct, SCOPUS, PeDro, BVS (virtual health library), and Google Scholar. Data extraction was independently performed by two authors. Twenty-five clinical trial-type studies that included dance and established outcome measures were included, and studies in which a musicalized exercise modality was used without the connotation of dance were excluded. RESULTS From the results of multiple studies, the short-term motor benefits of rhythmic auditory stimulation on gait parameters were highlighted. Furthermore, there was scientific evidence demonstrating the benefits of the cognitive and social parameters of group dancing as significant improvements in cognitive flexibility and processing speed were highlighted. Recent studies showed that interventions based on exercise and/or rhythmic choreography can reduce the risk of falls in patients with neurological disorders, thereby improving their quality of life. CONCLUSION These findings suggest that dance is an innovative and effective method that can be included in therapies as it allows for a promising prognosis in motor, cognitive, and social performances of patients with neurological disorders that alter mobility and quality of life.
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Affiliation(s)
- Daniel Aldana-Benítez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - María José Caicedo-Pareja
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Diana Patricia Sánchez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Leidy Tatiana Ordoñez-Mora
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
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24
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Delfa-Lobato L, Feliu-Torruella M, Cañete-Massé C, Ruiz-Torras S, Guàrdia-Olmos J. Benefits of Cultural Activities on People with Cognitive Impairment: A Meta-Analysis. Healthcare (Basel) 2023; 11:1854. [PMID: 37444688 DOI: 10.3390/healthcare11131854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Museums and cultural institutions are increasingly aware of both the interests and needs of society. Accordingly, these institutions are becoming allies in terms of health and well-being due to the importance of their social functions. Presently, many institutions create cultural activities aimed at cognitively impaired people, a group on the rise owing to the prevalence of dementia and the aging of society. Nevertheless, scientific evidence in this field remains scarce. As a result, the main objective of this research was to empirically evaluate and identify the benefits that cultural interventions can bring to cognitively impaired participants. METHOD A meta-analysis (MA) was performed following PRISMA guidelines. When inclusion and eligibility criteria had been established, articles were subsequently selected through a strategic search of Web of Science, SCOPUS, PubMed, and Medline. RESULTS Twenty-six studies met the eligibility criteria, involving a total of 1201 participants with cognitive impairment. The results showed a statistically non-significant effect size when analyzing these cultural interventions for cognitively impaired people overall. However, when conducting partial meta-analyses (MA'), focusing on studies related to a specific disease, a particular type of treatment, or a specific type of evaluation, the results concurred with the conclusion of the previous systematic review (SR). CONCLUSION Despite the high heterogeneity of the studies, benefits were identified in emotional well-being and social aspects but not in clinical ones such as the deterioration of cognitive or motor function, among others.
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Affiliation(s)
- Laia Delfa-Lobato
- Department of Applied Didactics, Faculty of Education, University of Barcelona, 08035 Barcelona, Spain
| | - Maria Feliu-Torruella
- Department of Applied Didactics, Faculty of Education, University of Barcelona, 08035 Barcelona, Spain
- Institute of Research in Education (IRE), University of Barcelona, 08035 Barcelona, Spain
| | - Cristina Cañete-Massé
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
- UB Institute of Complex Systems, University of Barcelona, 08035 Barcelona, Spain
| | - Silvia Ruiz-Torras
- Psychological Clinic, Josep Finestres Foundation, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain
- UB Institute of Complex Systems, University of Barcelona, 08035 Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, 08035 Barcelona, Spain
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25
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Álvarez-Bueno C, Deeks JJ, Cavero-Redondo I, Jolly K, Torres-Costoso AI, Price M, Fernandez-Rodriguez R, Martínez-Vizcaíno V. Effect of Exercise on Motor Symptoms in Patients With Parkinson's Disease: A Network Meta-analysis. J Geriatr Phys Ther 2023; 46:E87-E105. [PMID: 34392264 DOI: 10.1519/jpt.0000000000000322] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although the pharmacological approach may help with motor symptoms in Parkinson's disease (PD), they are clearly not the complete solution. Thus, for the treatment of PD motor symptoms, physical activity has been proposed as an effective intervention. METHODS A systematic search in MEDLINE, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases was conducted to identify randomized controlled trials testing the effectiveness of exercise interventions on motor symptoms of PD. Physical exercise interventions were divided into 9 categories: endurance, resistance, combined, balance, dance, alternative exercises, body weight supported, sensorimotor interventions including endurance exercise, and sensorimotor interventions not including endurance exercise. A pairwise meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups was carried out. RESULTS Fifty-six studies met the inclusion criteria, including 2740 participants, aged between 57.6 and 77.7 years. Results showed that sensorimotor training including endurance (effect size [ES]-1.09; 95% confidence interval [CI], -1.68 to -0.50), resistance (ES-0.82; 95% CI, -1.23 to -0.41), and dance (ES-0.64; 95% CI, -1.24 to -0.05) were the most effective physical activity interventions for mitigating PD motor symptoms. CONCLUSION Physical activity interventions are an effective strategy for the management of motor symptoms in patients with PD. Among the different exercise intervention programs, those including more complex and demanding activities (sensorimotor training including endurance, resistance, and dance) seem to be the most effective physical activity interventions.
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Affiliation(s)
- Celia Álvarez-Bueno
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Jonathan J Deeks
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Iván Cavero-Redondo
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
- Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Ana I Torres-Costoso
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Malcolm Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | | | - Vicente Martínez-Vizcaíno
- Social and Health Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
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26
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Omar Ahmad S, Longhurst J, Stiles D, Downard L, Martin S. A meta-analysis of exercise intervention and the effect on Parkinson's Disease symptoms. Neurosci Lett 2023; 801:137162. [PMID: 36863557 DOI: 10.1016/j.neulet.2023.137162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/16/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disease that is distinguished by tremors at rest, bradykinesia, hypokinesia, and postural instability, resulting in a progressive decline in performance of everyday activities. The non-motor symptoms that occur can include pain, depression, cognitive dysfunction, sleep issues, and anxiety (among others). Functionality is tremendously impaired by physical as well as non-motor symptoms. Recent treatment has begun to incorporate non-conventional interventions that are more functional and tailored to the patients with PD. The purpose of this meta-analysis was to determine the effectiveness of exercise interventions at alleviating PD symptoms, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS). Additionally, this review qualitatively explored whether endurance-based or non-endurance based exercise interventions were more beneficial at alleviating PD symptoms. Two reviewers screened the title and abstract records (n = 668) found in the initial search. Subsequently the reviewers completed full-text screening of the remaining articles for inclusion.. Following this, a total of 25 articles were considered to be eligible and included in the review and data was extracted for meta-analysis. The interventions lasted from 4 to 26 weeks. Results indicated a positive overall effect of therapeutic exercise on patients with PD, where the overall d-index was 0.155. Qualitatively no difference was observed between aerobic and non-aerobic forms of exercise.
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Affiliation(s)
- Syed Omar Ahmad
- Department of Occupational Science and Occupational Therapy, Saint Louis University, Doisy College of Health Sciences, Saint Louis, MO 63104, USA.
| | - Jason Longhurst
- Department of Physical Therapy and Athletic Training, Saint Louis University, Doisy College of Health Sciences, Saint Louis, MO 63104, USA.
| | - Dana Stiles
- Saint Louis University, Department of Psychology, Doisy College of Health Sciences, Saint Louis, MO 63108, USA.
| | - Lana Downard
- Department of Occupational Science and Occupational Therapy, Saint Louis University, Doisy College of Health Sciences, Saint Louis, MO 63104, USA.
| | - Stephanie Martin
- Department of Occupational Science and Occupational Therapy, Saint Louis University, Doisy College of Health Sciences, Saint Louis, MO 63104, USA.
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Sistarelli S, Annett LE, Lovatt PJ. Effects of Popping For Parkinson’s dance class on the mood of people with Parkinson’s disease. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2023. [DOI: 10.12968/ijtr.2021.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background/Aims Depression, low mood and apathy can affect people with Parkinson’s disease, impacting on their quality of life. The aim of this study was to investigate the effects of one Popping For Parkinson’s dance session on the mood of people with Parkinson’s disease. Methods A total of 33 people with Parkinson’s disease, with a mean age of 67.5 years (standard deviation 10.3 years), mean Parkinson’s level of 1.8 (standard deviation 1.6), took part in one Popping For Parkinson's dance class at four different locations: London (UK), Hatfield (UK), New York City (USA) and Turin (Italy). Participants’ mood was measured with the Profile of Mood States questionnaire at four time points: immediately before the dance class, immediately after the dance class, 24 hours after the dance class and 1 week after the dance class. Results Participants’ total mood score and the subscale score of vigour increased, while the subscales of tension, depression, and confusion decreased on the Profile of Mood States, significantly immediately after the dance intervention. However, at 24 hours and 1 week after the dance class, mood scores did not differ significantly compared with baseline measurements. The improvements in mood immediately after the dance class did not differ depending on sex, age, previous dance experience, the location of the dance class, stage of Parkinson’s disease, presence of tremor and deep brain stimulation treatment. Conclusions Participating in a Popping For Parkinson’s dance class boosts mood in the short term, and this improvement lasts less than 24 hours. This finding has implications for the provision of dance classes, suggesting that regular attendance may be necessary for sustained improvements. Further studies are needed to determine whether attending a series of Popping for Parkinson’s classes may have longer-term effects.
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Affiliation(s)
- Simone Sistarelli
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Lucy E Annett
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Peter J Lovatt
- Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Duarte JDS, Alcantara WA, Brito JS, Barbosa LCS, Machado IPR, Furtado VKT, dos Santos-Lobato BL, Pinto DS, Krejcová LV, Bahia CP. Physical activity based on dance movements as complementary therapy for Parkinson's disease: Effects on movement, executive functions, depressive symptoms, and quality of life. PLoS One 2023; 18:e0281204. [PMID: 36730266 PMCID: PMC9894447 DOI: 10.1371/journal.pone.0281204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/22/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive, neurodegenerative disease with motor symptoms that are well understood, but non-motor symptoms may be present and appear at different temporal stages of the disease. Physical activity based on dance movements is emerging as a complementary therapeutic approach to a range of PD symptoms as a multidimensional activity that requires rhythmic synchronization and more neuromuscular functions. OBJECTIVE To evaluate the effects of physical activity based on dance movements on the movement, executive functions, depressive symptoms, quality of life, and severity of PD in individuals diagnosed with PD. METHODS 13 individuals with PD (Hoehn & Yahr I-III, MDS-UPDRS 67.62 ± 20.83), underwent physical activity based on dance movements (2x week for 6 months). Participants were assessed at baseline and after 6 months on movement (POMA, TUG and MDS-UPDRS Part III), executive function (FAB), depressive symptoms (MADRS), quality of life (PDQ-39), and severity of PD (MDS-UPDRS TOTAL). Student's t-test was used to compare pre and post-intervention results. RESULTS We observed a significant improvement in the movement (balance and gait) by the POMA test, p = 0.0207, executive function by the FAB test, p = 0.0074, abstract reasoning and inhibitory control by the FAB, Conceptualization test, p = 0.0062, and Inhibitory Control, p = 0.0064, depressive symptoms assessed by the MADRS test significantly reduced, p = 0.0214, and the quality of life by the PDQ-39 had a significant increase after the intervention, p = 0.0006, showed significant improvements between the pre-and post-intervention periods of physical activity based on dance movements. CONCLUSION Physical activity based on dance movements contributed to significant improvements in movement (balance and gait), executive functions, especially in cognitive flexibility and inhibitory control, and the quality of life too. Sensorimotor integration, most cognitive processing and social skills may have contributed to the results. TRIAL REGISTRATION The study was registered in the Brazilian registry of clinical trials: RBR-3bhbrb5.
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Affiliation(s)
- Juliana dos Santos Duarte
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | | | - Juliana Silva Brito
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | | | | | | | | | - Denise Silva Pinto
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Lane Viana Krejcová
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | - Carlomagno Pacheco Bahia
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- * E-mail:
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Ernst M, Folkerts AK, Gollan R, Lieker E, Caro-Valenzuela J, Adams A, Cryns N, Monsef I, Dresen A, Roheger M, Eggers C, Skoetz N, Kalbe E. Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 1:CD013856. [PMID: 36602886 PMCID: PMC9815433 DOI: 10.1002/14651858.cd013856.pub2] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Physical exercise is effective in managing Parkinson's disease (PD), but the relative benefit of different exercise types remains unclear. OBJECTIVES To compare the effects of different types of physical exercise in adults with PD on the severity of motor signs, quality of life (QoL), and the occurrence of adverse events, and to generate a clinically meaningful treatment ranking using network meta-analyses (NMAs). SEARCH METHODS An experienced information specialist performed a systematic search for relevant articles in CENTRAL, MEDLINE, Embase, and five other databases to 17 May 2021. We also searched trial registries, conference proceedings, and reference lists of identified studies up to this date. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing one type of physical exercise for adults with PD to another type of exercise, a control group, or both. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. A third author was involved in case of disagreements. We categorized the interventions and analyzed their effects on the severity of motor signs, QoL, freezing of gait, and functional mobility and balance up to six weeks after the intervention using NMAs. Two review authors independently assessed the risk of bias using the risk of bias 2 (RoB 2) tool and rated the confidence in the evidence using the CINeMA approach for results on the severity of motor signs and QoL. We consulted a third review author to resolve any disagreements. Due to heterogeneous reporting of adverse events, we summarized safety data narratively and rated our confidence in the evidence using the GRADE approach. MAIN RESULTS We included 156 RCTs with a total of 7939 participants with mostly mild to moderate disease and no major cognitive impairment. The number of participants per study was small (mean 51, range from 10 to 474). The NMAs on the severity of motor signs and QoL included data from 71 (3196 participants), and 55 (3283 participants) trials, respectively. Eighty-five studies (5192 participants) provided safety data. Here, we present the main results. We observed evidence of beneficial effects for most types of physical exercise included in our review compared to a passive control group. The effects on the severity of motor signs and QoL are expressed as scores on the motor scale of the Unified Parkinson Disease Rating Scale (UPDRS-M) and the Parkinson's Disease Questionnaire 39 (PDQ-39), respectively. For both scales, higher scores denote higher symptom burden. Therefore, negative estimates reflect improvement (minimum clinically important difference: -2.5 for UPDRS-M and -4.72 for PDQ-39). Severity of motor signs The evidence from the NMA (71 studies; 3196 participants) suggests that dance has a moderate beneficial effect on the severity of motor signs (mean difference (MD) -10.32, 95% confidence interval (CI) -15.54 to -4.96; high confidence), and aqua-based, gait/balance/functional, and multi-domain training might have a moderate beneficial effect on the severity of motor signs (aqua-based: MD -7.77, 95% CI -13.27 to -2.28; gait/balance/functional: MD -7.37, 95% CI -11.39 to -3.35; multi-domain: MD -6.97, 95% CI -10.32 to -3.62; low confidence). The evidence also suggests that mind-body training and endurance training might have a small beneficial effect on the severity of motor signs (mind-body: MD -6.57, 95% CI -10.18 to -2.81; endurance: MD -6.43, 95% CI -10.72 to -2.28; low confidence). Flexibility training might have a trivial or no effect on the severity of motor signs (MD 2.01, 95% CI -4.82 to 8.98; low confidence). The evidence is very uncertain about the effects of strength/resistance training and "Lee Silverman Voice training BIG" (LSVT BIG) on the severity of motor signs (strength/resistance: MD -6.97, 95% CI -11.93 to -2.01; LSVT BIG: MD -5.49, 95% CI -14.74 to 3.62; very low confidence). Quality of life The evidence from the NMA (55 studies; 3283 participants) suggests that aqua-based training probably has a large beneficial effect on QoL (MD -14.98, 95% CI -23.26 to -6.52; moderate confidence). The evidence also suggests that endurance training might have a moderate beneficial effect, and that gait/balance/functional and multi-domain training might have a small beneficial effect on QoL (endurance: MD -9.16, 95% CI -15.68 to -2.82; gait/balance/functional: MD -5.64, 95% CI -10.04 to -1.23; multi-domain: MD -5.29, 95% CI -9.34 to -1.06; low confidence). The evidence is very uncertain about the effects of mind-body training, gaming, strength/resistance training, dance, LSVT BIG, and flexibility training on QoL (mind-body: MD -8.81, 95% CI -14.62 to -3.00; gaming: MD -7.05, 95% CI -18.50 to 4.41; strength/resistance: MD -6.34, 95% CI -12.33 to -0.35; dance: MD -4.05, 95% CI -11.28 to 3.00; LSVT BIG: MD 2.29, 95% CI -16.03 to 20.44; flexibility: MD 1.23, 95% CI -11.45 to 13.92; very low confidence). Adverse events Only 85 studies (5192 participants) provided some kind of safety data, mostly only for the intervention groups. No adverse events (AEs) occurred in 40 studies and no serious AEs occurred in four studies. AEs occurred in 28 studies. The most frequently reported events were falls (18 studies) and pain (10 studies). The evidence is very uncertain about the effect of physical exercise on the risk of adverse events (very low confidence). Across outcomes, we observed little evidence of differences between exercise types. AUTHORS' CONCLUSIONS We found evidence of beneficial effects on the severity of motor signs and QoL for most types of physical exercise for people with PD included in this review, but little evidence of differences between these interventions. Thus, our review highlights the importance of physical exercise regarding our primary outcomes severity of motor signs and QoL, while the exact exercise type might be secondary. Notably, this conclusion is consistent with the possibility that specific motor symptoms may be treated most effectively by PD-specific programs. Although the evidence is very uncertain about the effect of exercise on the risk of adverse events, the interventions included in our review were described as relatively safe. Larger, well-conducted studies are needed to increase confidence in the evidence. Additional studies recruiting people with advanced disease severity and cognitive impairment might help extend the generalizability of our findings to a broader range of people with PD.
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Affiliation(s)
- Moritz Ernst
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Emma Lieker
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julia Caro-Valenzuela
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nora Cryns
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Resarch, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mandy Roheger
- Ambulatory Assessment in Psychology, Department of Psychology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Simpkins C, Yang F. Do dance style and intervention duration matter in improving balance among people with Parkinson's disease? A systematic review with meta-analysis. Parkinsonism Relat Disord 2023; 106:105231. [PMID: 36470708 DOI: 10.1016/j.parkreldis.2022.105231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/25/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Impaired balance is a common symptom that increases fall risk in people with Parkinson's disease (PwPD). Although previous meta-analyses concluded that dance-based interventions could improve balance in PwPD, they have limitations, such as small samples and low rigor. Another overlooked issue is whether the effects of dance-based interventions depend on dance style and training duration. The primary purpose of this meta-analysis was to further examine the efficacy of dance-based interventions in improving balance in PwPD. The secondary goals were to compare the intervention efficacy of different dance styles and durations. METHODS Fourteen randomized controlled trials (RCT) examining the effect of dance-based treatment on improving balance among 612 PwPD were included. Effect size (ES) was calculated as the standardized mean difference. Meta-analyses (one primary analysis and three subgroup analyses) were completed using random-effects models. RESULTS Results showed a medium overall ES of 0.57 (95% confidence interval or CI: [0.29,0.84], p < 0.0001) in favor of dance versus control on improving balance in PwPD. The subgroup analysis of six dance styles revealed various ES ranging 0.40-2.00. Balance was significantly improved with dance compared to control group for 12+ week interventions (ES = 0.72, 95%CI: [0.37,1.08], p < 0.0001). Interventions with 60- and 90-min classes produced similar ES for improving PwPD's balance (60-min ES = 0.54; 90-min ES = 0.68). CONCLUSION Dance-based interventions (particularly of 12+ weeks) could effectively improve balance among PwPD. More high-quality RCT are needed to determine the most beneficial dance styles and session lengths. These findings could inform future studies for designing/deploying effective dance-based balance training and fall prevention programs for PwPD.
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Affiliation(s)
- Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, USA.
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van Wamelen DJ, Rukavina K, Podlewska AM, Chaudhuri KR. Advances in the Pharmacological and Non-pharmacological Management of Non-motor Symptoms in Parkinson's Disease: An Update Since 2017. Curr Neuropharmacol 2023; 21:1786-1805. [PMID: 35293295 PMCID: PMC10514535 DOI: 10.2174/1570159x20666220315163856] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Non-motor symptoms (NMS) are an important and ubiquitous determinant of quality of life in Parkinson's disease (PD). However, robust evidence for their treatment is still a major unmet need. OBJECTIVE This study aimed to provide an updated review on advances in pharmacological, nonpharmacological, and exercise-based interventions for NMS in PD, covering the period since the publication of the MDS Task Force Recommendations. METHODS We performed a literature search to identify pharmacological, non-pharmacological, and exercise-based interventions for NMS in PD. As there are recent reviews on the subject, we have only included studies from the 1st of January 2017 to the 1st of December 2021 and limited our search to randomised and non-randomised (including open-label) clinical trials. RESULTS We discuss new strategies to manage NMS based on data that have become available since 2017, for instance, on the treatment of orthostatic hypotension with droxidopa, several dopaminergic treatment options for insomnia, and a range of non-pharmacological and exercise-based interventions for cognitive and neuropsychiatric symptoms, pain, and insomnia and excessive sleepiness. CONCLUSION Recent evidence suggests that targeted non-pharmacological treatments, as well as some other NMS management options, may have a significant beneficial effect on the quality of life and need to be considered in the pathways of treatment of PD.
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Affiliation(s)
- Daniel J. van Wamelen
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Katarina Rukavina
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Aleksandra M. Podlewska
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - K. Ray Chaudhuri
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, Division of Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
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Folkerts AK, Nielsen J, Gollan R, Lansu A, Solfronk D, Monsef I, Ernst M, Skoetz N, Zeuner KE, Kalbe E. Physical Exercise as a Potential Treatment for Fatigue in Parkinson's Disease? A Systematic Review and Meta-Analysis of Pharmacological and Non-Pharmacological Interventions. JOURNAL OF PARKINSON'S DISEASE 2023; 13:659-679. [PMID: 37334618 PMCID: PMC10473113 DOI: 10.3233/jpd-225116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Fatigue is one of the most common and debilitating non-motor symptoms among patients with Parkinson's disease (PD) and significantly impacts quality of life. Therefore, effective treatment options are needed. OBJECTIVE To provide an update on randomized controlled trials (RCTs) including pharmacological and non-pharmacological (but non-surgical) treatments that examine the effects of fatigue on PD patients. METHODS We searched the MEDLINE, EMBASE, PsycINFO, CENTRAL, and CINAHL databases for (cross-over) RCTs on pharmacological and non-pharmacological interventions for treating fatigue in PD patients until May 2021. Meta-analyses for random-effects models were calculated when two or more studies on the same treatment option were available using standardized mean differences (SMDs) with 95% confidence intervals (CIs). RESULTS Fourteen pharmacological and 16 non-pharmacological intervention RCTs were identified. For pharmacological approaches, a meta-analysis could only be performed for modafinil compared to placebo (n = 2) revealing a non-significant effect on fatigue (SMD = - 0.21, 95% CI - 0.74-0.31, p = 0.43). Regarding non-pharmacological approaches, physical exercise (n = 8) following different training approaches versus passive or placebo control groups showed a small significant effect (SMD = - 0.37, 95% CI - 0.69- - 0.05, p = 0.02) which could not be demonstrated for acupuncture vs. sham-acupuncture (SMD = 0.16, 95% CI - 0.19-0.50, p = 0.37). CONCLUSION Physical exercise may be a promising strategy to treat fatigue in PD patients. Further research is required to examine the efficacy of this treatment strategy and further interventions. Future studies should differentiate treatment effects on physical and mental fatigue as the different underlying mechanisms of these symptoms may lead to different treatment responses. More effort is required to develop, evaluate, and implement holistic fatigue management strategies for PD patients.
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Affiliation(s)
- Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jörn Nielsen
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Romina Gollan
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Annika Lansu
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dominik Solfronk
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ina Monsef
- Evidence-based Medicine, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Moritz Ernst
- Evidence-based Medicine, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Evidence-based Medicine, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Yang CL, Huang JP, Wang TT, Tan YC, Chen Y, Zhao ZQ, Qu CH, Qu Y. Effects and parameters of community-based exercise on motor symptoms in Parkinson's disease: a meta-analysis. BMC Neurol 2022; 22:505. [PMID: 36581847 PMCID: PMC9797903 DOI: 10.1186/s12883-022-03027-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/13/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Community-based exercise is a continuation and complement to inpatient rehabilitation for Parkinson's disease and does not require a professional physical therapist or equipment. The effects, parameters, and forms of each exercise are diverse, and the effect is affected by many factors. A meta-analysis was conducted to determine the effect and the best parameters for improving motor symptoms and to explore the possible factors affecting the effect of community-based exercise. METHODS: We conducted a comprehensive search of six databases: PEDro, PubMed/Medline, CENTRAL, Scopus, Embase, and WOS. Studies that compared community-based exercise with usual care were included. The intervention mainly included dance, Chinese martial arts, Nordic walking, and home-based exercise. The primary outcome measure was the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) score. The mean difference (95% CI) was used to calculate the treatment outcomes of continuous outcome variables, and the I2 statistic was used to estimate the heterogeneity of the statistical analysis. We conducted subgroup analysis and meta-regression analysis to determine the optimal parameters and the most important influencing factors of the exercise effect. RESULTS: Twenty-two studies that enrolled a total of 809 subjects were included in the analysis. Exercise had a positive effect on the UPDRS-III (MD = -5.83; 95% CI, -8.29 to -3.37), Timed Up and Go test (MD = -2.22; 95% CI -3.02 to -1.42), UPDRS ((MD = -7.80; 95% CI -10.98 to -6.42), 6-Minute Walk Test (MD = 68.81; 95% CI, 32.14 to 105.48), and Berg Balance Scale (MD = 4.52; 95% CI, 2.72 to 5.78) scores. However, the heterogeneity of each included study was obvious. Weekly frequency, age, and duration of treatment were all factors that potentially influenced the effect. CONCLUSIONS This meta-analysis suggests that community-based exercise may benefit motor function in patients with PD. The most commonly used modalities of exercise were tango and tai chi, and the most common prescription was 60 min twice a week. Future studies should consider the influence of age, duration of treatment, and weekly frequency on the effect of exercise. PROSPERO TRIAL REGISTRATION NUMBER CRD42022327162.
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Affiliation(s)
- Chun-Lan Yang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.508104.8Minda Hospital of Hubei Minzu University, Enshi, 445000 Hubei China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Jia-Peng Huang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Ting-Ting Wang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Ying-Chao Tan
- Enshi Prefecture Central Hospital, Enshi, 445000 Hubei China
| | - Yin Chen
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Zi-Qi Zhao
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Chao-Hua Qu
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
| | - Yun Qu
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan China
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Wang Y, Sun X, Li F, Li Q, Jin Y. Efficacy of non-pharmacological interventions for depression in individuals with Parkinson's disease: A systematic review and network meta-analysis. Front Aging Neurosci 2022; 14:1050715. [PMID: 36438007 PMCID: PMC9691406 DOI: 10.3389/fnagi.2022.1050715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/26/2022] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Depression in Parkinson's disease (PD) is a major health concern worldwide. Recently, an increasing number of non-pharmacological interventions have been used in PD to alleviate depressive symptoms. However, it is uncertain which intervention is the best, and related evidence is limited. This network meta-analysis was performed to compare and rank non-pharmacological interventions for PD and analyze their effects on depression to provide evidence for clinicians to choose appropriate non-pharmacological management options. METHODS The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched from inception to April 7, 2022. Two authors screened all studies, extracted the data, and evaluated the methodological quality. STATA software version 16.0 was used to conduct the network meta-analysis. RESULTS Our network meta-analysis included 62 studies involving 3,050 participants and 35 non-pharmacological interventions. Although most non-pharmacological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values indicated that the best non-pharmacological intervention for depression was dance (82.3%), followed by LSVT-BIG therapy (77.4%), and CBT (73.6%). CONCLUSION Dance can be considered as an effective therapy for improving depression in patients with PD. In the future, more strictly designed trials are needed to verify the conclusions of this network meta-analysis.
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Affiliation(s)
- Yuxin Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xue Sun
- Nursing Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fei Li
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Qi Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yi Jin
- Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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Zhen K, Zhang S, Tao X, Li G, Lv Y, Yu L. A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson's disease. NPJ Parkinsons Dis 2022; 8:146. [PMID: 36316416 PMCID: PMC9622812 DOI: 10.1038/s41531-022-00418-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Previous studies have shown that aerobic exercise is an effective way to improve symptoms of Parkinson's disease (PD). The aim of this study [PROSPERO CRD42022340730] was to explore the effects of aerobic exercises on balance, gait, motor function, and quality of life in PD patients. Searches were performed in PubMed, Web of Science, and EBSCO electronic databases. The Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1287 search records initially identified, 20 studies were considered eligible for systematic review and meta-analysis. There was a significant effect of aerobic exercise on improving timed up and go test [standardized mean difference (SMD), -0.41 (95% CI, -0.61 to -0.22), p < 0.00001], Berg Balance Scale [0.99 (95% CI, 0.76 to 1.23), p < 0.00001], stride/step length [0.32 (95% CI, 0.03 to 0.61), p = 0.03], gait velocity [0.49 (95% CI, 0.20 to 0.78), p = 0.0009], Unified Parkinson's Disease Rating Scale Part-III [-0.40 (95% CI, -0.55 to -0.24), p < 0.00001], and 6-minute walking test [0.35 (95% CI, 0.13 to 0.56), p = 0.002] in people with PD, but not in step cadence [-0.08 (95% CI, -0.43 to 0.27), p = 0.65] and Parkinson's Disease Questionnaire-39 [-0.113 (95% CI, -0.39 to 0.13), p = 0.32]. Aerobic exercise had beneficial effects in improving balance, gait (velocity and stride/step length), and motor function in PD patients. However, aerobic exercise had no significant associations with the step cadence and quality of life in PD patients.
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Affiliation(s)
- Kai Zhen
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Gen Li
- grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- grid.411614.70000 0001 2223 5394Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China ,grid.411614.70000 0001 2223 5394Department of Sports Performance, Beijing Sport University, Beijing, China
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Weintraub D, Aarsland D, Biundo R, Dobkin R, Goldman J, Lewis S. Management of psychiatric and cognitive complications in Parkinson's disease. BMJ 2022; 379:e068718. [PMID: 36280256 DOI: 10.1136/bmj-2021-068718] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Neuropsychiatric symptoms (NPSs) such as affective disorders, psychosis, behavioral changes, and cognitive impairment are common in Parkinson's disease (PD). However, NPSs remain under-recognized and under-treated, often leading to adverse outcomes. Their epidemiology, presentation, risk factors, neural substrate, and management strategies are incompletely understood. While psychological and psychosocial factors may contribute, hallmark PD neuropathophysiological changes, plus the associations between exposure to dopaminergic medications and occurrence of some symptoms, suggest a neurobiological basis for many NPSs. A range of psychotropic medications, psychotherapeutic techniques, stimulation therapies, and other non-pharmacological treatments have been studied, are used clinically, and are beneficial for managing NPSs in PD. Appropriate management of NPSs is critical for comprehensive PD care, from recognizing their presentations and timing throughout the disease course, to the incorporation of different therapeutic strategies (ie, pharmacological and non-pharmacological) that utilize a multidisciplinary approach.
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Affiliation(s)
- Daniel Weintraub
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
| | - Roberta Biundo
- Department of General Psychology, University of Padua, Padua, Italy
- Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers-The State University of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer Goldman
- Shirley Ryan AbilityLab, Parkinson's Disease and Movement Disorders, Chicago, IL
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
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Effect of Long-term Exercise Therapy on Motor Symptoms in Parkinson Disease Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2022; 101:905-912. [PMID: 35695530 DOI: 10.1097/phm.0000000000002052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The aims of the study were to assess the effectiveness of long-term exercise therapy (≥12 wks) for patients with Parkinson disease and to derive specific suggestions on how the motor symptom improvements can be optimized by exercise type and exercise dose. DESIGN The PubMed, Web of Science, Cochrane Central Register, Embase, Scopus, and CNKI databases were searched up to January 2021 for randomized controlled trials focusing on the effects of long-term exercise for Parkinson disease. Two researchers independently evaluated the quality of papers using the PEDro scale. Twenty-six studies with a total of 1243 participants were included. RESULTS Tai Chi, resistance training, and dance provide significant improvements in physical function and functional mobility. Furthermore, Tai Chi and dance result in balance benefits. However, walking capacity outcomes did not improve after Tai Chi and resistance training but did improve after dance. With an increase in the intervention duration or length of each session, the effect sizes of exercise on these outcomes increased; higher benefits of exercise on these outcomes were observed at a frequency of 2 times/wk. CONCLUSIONS Long-term exercise therapy is an effective treatment for improving motor symptoms, with dance being an ideal exercise choice. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES Upon completion of this article, the reader should be able to: (1) Recognize that long-term exercise slows clinical progression of motor symptoms in patients with Parkinson disease; (2) Acquire knowledge regarding the effectiveness of long-term exercise therapy on motor symptoms in Parkinson disease; and (3) Incorporate specific suggestions on dose-response relationships of different exercise therapy on motor symptoms in Parkinson disease. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Which type of mind-body exercise is most effective in improving functional performance and quality of life in patients with Parkinson's disease? A systematic review with network meta-analysis. Acta Neurol Belg 2022; 122:1433-1446. [PMID: 36056269 DOI: 10.1007/s13760-022-02070-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/15/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Several studies have investigated the effect of mind-body exercise (MBE) on functional performance and health-related quality of life (HRQoL) in Parkinson's disease (PD), but it is still very difficult for clinicians to make informed decision on the best mind-body exercise for PD. PURPOSE We analyzed the relative efficacy of MBE (yoga, Tai-Chi, Pilates, Qigong, and dance) in improving functional performance and HRQoL in patients with PD. METHODS A systematic review of randomized controlled trials (RCTs) was performed using network meta-analysis (NMA), searching the following databases: Cochrane, Web of Science, and PubMed using specific keywords until December 28, 2021, assessing the effects of MBE on functional performance and HRQoL in patients with PD. RESULTS This review included 60 RCTs with 2037 participants. A ranking of MBE for modifying various aspects of functional performance and HRQoL was achieved. Pairwise NMA showed Pilates to be the most effective in improving functional mobility (MD: - 3.81; 95% CI (- 1.55, - 6.07) and balance performance (SMD: 2.83; 95% CI (1.87, 3.78). Yoga (MD: - 5.95; 95% CI (- 8.73, - 3.16) and dance (MD: - 5.87; 95% CI (- 8.73, - 3.01) to be the most effective in improving motor function, whereas Qigong (MD: 0.32; 95% CI (0.00, 0.64) was most effective in improving gait speed. Considering HRQoL, dance was found to be the most effective (SMD: - 0.36; 95% CI (- 0.70, -0.01). CONCLUSION MBE should be considered an effective strategy for improving functional performance and HRQoL in patients with PD. The most effective MBE intervention varied with the functional performance domain. Dance was an effective exercise for improving HRQoL among people with PD. PROSPERO REGISTRATION ID CRD42022301030.
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Patel RD, Mans KB. Review: Effect of Supplemental Activities on Motor and Nonmotor Outcomes in the Parkinson’s Population. AMERICAN JOURNAL OF DANCE THERAPY 2022. [DOI: 10.1007/s10465-022-09367-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Karpodini CC, Dinas PC, Angelopoulou E, Wyon MA, Haas AN, Bougiesi M, Papageorgiou SG, Koutedakis Y. Rhythmic cueing, dance, resistance training, and Parkinson's disease: A systematic review and meta-analysis. Front Neurol 2022; 13:875178. [PMID: 36034281 PMCID: PMC9413961 DOI: 10.3389/fneur.2022.875178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of the present systematic review and meta-analysis was to synthesize evidence associated with the functional and clinical effectiveness of rhythmic cueing, dance, or resistance training (RT) on motor and non-motor parameters in Parkinson's Disease patients, and to provide a comparative perspective not offered by existing systematic reviews. Methodology Eligibility criteria for selecting studies retained no restrictions in methodological design and included interventions of rhythmic cueing, dance, RT, and measurements of motor and non-motor parameters. Animal studies, reviews, editorials, conferences, magazines, and gray literature articles were excluded. Two independent investigators searched Cochrane Library, Medline, PubMed, and SPORTDiscus from the date of their inception until 1 June 2021. The ROBINS-I tool was employed for the non-randomized controlled trials, and the updated for Risk of Bias 2 tool of Cochrane Library used for randomized controlled trials. For meta-analyses, the RevMan 5.4.13 software was used. For incompatible meta-analysis studies, a narrative data synthesis was conducted. Results A total of 49 studies included in the systematic review involving 3767 PD participants. Meta-analyses revealed that rhythmic cueing training assists gait velocity (p = 0.01), stride length (p = 0.01), and motor symptoms (p = 0.03). Similarly, dance training benefits stride length (p = 0.05), lower extremity function-TUG (p = 0.01), and motor symptoms (p = 0.01), whilst RT improves lower extremity function-TUG (p = 0.01), quality of life (p = 0.01), knee flexion (p = 0.02), and leg press (p = 0.01). Subgroup analyses have shown non-significant differences in gait velocity (p = 0.26), stride length (p = 0.80), functional mobility-TUG (p = 0.74), motor symptoms-UPDRS-III (p = 0.46), and quality of life-PDQ39 (p = 0.44). Conclusion Rhythmic cueing, dance, or RT positively affect the examined outcomes, with rhythmic cueing to be associated with three outcomes (Gait, Stride, and UPDRS-III), dance with three outcomes (TUG, Stride, and UPDRS-III), and RT with two outcomes (TUG and PDQ-39). Subgroup analyses confirmed the beneficial effects of these forms of exercise. Clinicians should entertain the idea of more holistic exercise protocols aiming at improving PD manifestations.International Prospective Register of systematic reviews (PROSPERO) (registration number: CRD42020212380).
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Affiliation(s)
- Claire Chrysanthi Karpodini
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Petros C. Dinas
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Efthalia Angelopoulou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Matthew A. Wyon
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Aline Nogueira Haas
- School of Physical Education Physiotherapy and Dance, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maria Bougiesi
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Sokratis G. Papageorgiou
- First Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition University Hospital, Athens, Greece
| | - Yiannis Koutedakis
- Sport and Physical Activity Research Centre, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Functional Architecture of Mammals in their Environment Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
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Wu CC, Xiong HY, Zheng JJ, Wang XQ. Dance movement therapy for neurodegenerative diseases: A systematic review. Front Aging Neurosci 2022; 14:975711. [PMID: 36004000 PMCID: PMC9394857 DOI: 10.3389/fnagi.2022.975711] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe proportion of the world's elderly population continues to rise, and the treatment and improvement of neurodegenerative diseases have become issue of public health importance as people live longer and many countries have aging populations. This systematic review aims to discuss the effects of dance movement therapy (DMT) on motor function, cognitive deficit, mood, and quality of life in people with neurodegenerative diseases, such as Parkinson's disease (PD), mild cognitive impairment (MCI), Alzheimer's disease (AD).MethodsTwo reviewers independently conducted systematic search on the Cochrane library, PubMed database, Web of Science Core Collection database, and Physiotherapy Evidence database until February 1, 2022. Only systematic analyses and randomized controlled trials were included and further analyzed.ResultsThirty-three studies on PD, 16 studies on MCI, 4 studies on AD were obtained. This systematic review found that DMT substantially improved the global cognitive function, memory, and executive function on the population with MCI. Compared with the non-dance group, DMT remarkably improved general disease condition, balance, and gait for individuals with PD. The evidence of the efficacy of DMT on AD is insufficient, and further research is needed.ConclusionDMT can effectively improve the motor function and cognitive deficits in neurodegenerative diseases. Positive effects of DMT on the mood and quality of life in ND patients are controversial and require further evidence. Future research on the effects of DMT on AD requires scientific design, large sample size, long-term comprehensive intervention, and clear reporting standards.Systematic review registrationwww.osf.io/wktez, identifier: 10.17605/OSF.IO/UYBKT.
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Affiliation(s)
- Cheng-Cheng Wu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Huan-Yu Xiong
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jie-Jiao Zheng
- Huadong Hospital, Shanghai, China
- *Correspondence: Jie-Jiao Zheng
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- Xue-Qiang Wang
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Tian J, Kang Y, Liu P, Yu H. Effect of Physical Activity on Depression in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116849. [PMID: 35682432 PMCID: PMC9180645 DOI: 10.3390/ijerph19116849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide, and approximately 50% of PD patients suffer from depression. We aim to determine the effects of physical activity on depression in PD patients and to provide scientific evidence-based exercise prescriptions for PD patients. A systematic review was conducted by searching PubMed, Embase, Cochrane Library, and PsycInfo until February 2022 for randomized controlled trial (RCT) studies published in English. The primary outcome was a score on a depression scale. A total of 14 RCTs involving 516 patients with PD were included in this study. The results of the meta-analysis showed that physical activity had a moderate and significant improvement in depression in PD patients (SMD = −0.60; 95% CI = −0.79 to −0.41; p < 0.00001). Subgroup analysis indicated that resistance exercise for 60−90 min more than 4 times per week for up to 12 weeks had a significant effect on PD patients who have had the disease for more than 5 years. Meta-regression showed that intervention type, intervention time, intervention frequency, intervention period, age, and disease duration were not sources of heterogeneity. Physical activity may reduce depression in PD patients. However, other larger sample sizes and high-quality studies are needed to validate these effects in the future.
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Affiliation(s)
- Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Yujie Kang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Peifeng Liu
- Department of Physical Education, Central South University, Changsha 410083, China;
| | - Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
- Correspondence:
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Wang LL, Sun CJ, Wang Y, Zhan TT, Yuan J, Niu CY, Yang J, Huang S, Cheng L. Effects of dance therapy on non-motor symptoms in patients with Parkinson's disease: a systematic review and meta-analysis. Aging Clin Exp Res 2022; 34:1201-1208. [PMID: 35091970 DOI: 10.1007/s40520-021-02030-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parkinson's disease (PD) represents the second most common neurodegenerative disease. OBJECTIVE To evaluate the effects of dance therapy (DT) aimed at improving non-motor symptoms in PD. METHODS Studies were performed through PubMed, Web of Science, The Cochrane Library, Embase, and Science Direct from inception to October 27, 2021. The data were screened independently by two reviewers, and the quality of the papers was assessed using the Cochrane manual. The included studies were randomized controlled trials and quasi-randomized controlled trials, reporting random-effects standardized mean differences, and 95% confidence intervals as the effect size. I2 statistics were used to assess heterogeneity. The main outcomes included the Montreal Cognitive Assessment Scale (MOCA), Baker Depression Scale (BDI), Parkinson's Fatigue Scale (FPS-16), and Apathy Scale (AS). RevMan 5.3 software was integrated for meta-analysis. RESULTS Nine literatures were analyzed for the meta-analysis with a total of 307 patients. Random effects showed that DT significantly improved cognitive of PD (MD = 1.50, 95% CI [0.52, 2.48], P = 0.0003; I2 = 51%). However, this meta-analysis demonstrated that dance therapy had no significance for improving depression (MD = - 1.33, 95% CI [- 4.11, 1.45], P = 0.35; I2 = 79%), fatigue (MD = 0.26, 95% CI [- 0.31, 0.83], P = 0.37; I2 = 0%), and apathy (MD = 0.07, 95% CI [- 2.55, 2.69], P = 0.96; I2 = 50%). CONCLUSION The meta-analysis suggests that dance can improve cognitive function in PD.
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Affiliation(s)
- Li-Li Wang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Cai-Jie Sun
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Yan Wang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Ting-Ting Zhan
- Department of Brain Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, No. 117 Meishan Street, Hefei, 230031, Anhui, China.
| | - Juan Yuan
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Cong-Ying Niu
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Jie Yang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Shan Huang
- School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
| | - Ling Cheng
- School of Humanities and International Educational Exchange, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China
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Effects of Ten Different Exercise Interventions on Motor Function in Parkinson’s Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials. Brain Sci 2022; 12:brainsci12060698. [PMID: 35741584 PMCID: PMC9221238 DOI: 10.3390/brainsci12060698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this study was to evaluate ten exercise interventions (YOGA: yoga training, RT: resistance training, AQU: aquatic training, TAI: Taiji Qigong training, TRD: treadmill training, VR: virtual reality training, DANCE: musical dance training, WKT: walking training, CYC: cycling training, BDJ: Baduanjin Qigong training) on motor function in Parkinson’s disease (PD) patients. Design: Through searching PubMed, Embase, Cochrane Library, Web of Science, and CNKI, only randomized controlled trials (RCTs) were collected to study the effects of the ten exercise interventions on motor function in patients with Parkinson’s disease. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool. Results: The RCTs were collected between the earliest available date and April 2022. Sixty RCTs were included and the total sample size used in the study was 2859. The results of the network meta-analysis showed that DANCE can significantly improve patients’ Berg Balance Scale (BBS) (SUCRA = 78.4%); DANCE can significantly decline patients’ Unified Parkinson’s Disease Rating Scale score (UPDRS) (SUCRA = 72.3%) and YOGA can significantly decline patients’ Timed-Up-and-Go score (TUGT) (SUCRA = 78.0%). Conclusion: Based on the network meta-analysis and SUCRA ranking, we can state that dance, yoga, virtual reality training and resistance training offers better advantages than other exercise interventions for patients’ motor function.
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Rodziewicz-Flis EA, Kawa M, Skrobot WR, Flis DJ, Wilczyńska D, Szaro-Truchan M, Bolek-Adamek J, Kaczor JJ. The positive impact of 12 weeks of dance and balance training on the circulating amyloid precursor protein and serotonin concentration as well as physical and cognitive abilities in elderly women. Exp Gerontol 2022; 162:111746. [PMID: 35217193 DOI: 10.1016/j.exger.2022.111746] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/08/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study aimed to compare the effectiveness of 12-weeks dance training with balance training on fall risk, physical and cognitive functions. The study's second aim was to evaluate the association between physical and cognitive functions with circulating markers of neurodegeneration and cognitive impairments in elders. MATERIALS AND METHODS 30 older women (aged 73.3 ± 4.5) were randomly assigned into three groups: balance training (BG), dance training (DG) and control group (CG). To assess the study aims Time up and go test (TUG), 6 minute walk test (6MWT), determination test (DT), blood amyloid precursor protein (APP) and serotonin concentration were performed. RESULTS The results showed an improvement in 6MWT (p = 0.0001 for DG and BD), walking speed (p = 0.0001 for DG and BG) and TUG, only for DG (p = 0.0013). The number of correct responses in DT increased in both groups (p = 0.014 and p = 0.005, for DG and BG, respectively). In DG the increase in the total number of reactions was observed (p = 0.013). The improvement in cognitive and physical functions was associated with an increase in APP (p = 0.036 and p = 0.014) and a decrease in serotonin concentrations (p = 0.042 and p = 0.049), respectively in DG and BG. CONCLUSION Dance training intervention could have more benefits on elders' physical and cognitive functions. However, both trainings may be important factors modifying the concentration of circulating proteins associated with neurodegenerative and cognitive disorders.
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Affiliation(s)
- Ewa Aleksandra Rodziewicz-Flis
- Department of Basic Physiotherapy, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Małgorzata Kawa
- Department of Basic Physiotherapy, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Wojciech Romuald Skrobot
- Department of Clinical Physiotherapy, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Damian Józef Flis
- Department of Pharmaceutical Pathophysiology, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland.
| | - Dominika Wilczyńska
- Department of Psychology, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Marzena Szaro-Truchan
- Department of Basic Physiotherapy, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Justyna Bolek-Adamek
- Department of Fitness, Gdansk University of Physical Education and Sport, K. Gorkiego 1 Street, 80-336 Gdansk, Poland.
| | - Jan Jacek Kaczor
- Department of Animal and Human Physiology, University of Gdansk, J Bazynskiego 8 Street, 80-308 Gdansk, Poland.
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Wang K, Li K, Zhang P, Ge S, Wen X, Wu Z, Yao X, Jiao B, Sun P, Lv P, Lu L. Mind–Body Exercises for Non-motor Symptoms of Patients With Parkinson’s Disease: A Systematic Review and Meta-Analysis. Front Aging Neurosci 2021; 13:770920. [PMID: 36226304 PMCID: PMC9549381 DOI: 10.3389/fnagi.2021.770920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to systematically evaluate the effects of mind–body exercise on global cognitive function, depression, sleep disorders, fatigue level, and quality of life (QOL) in a Parkinson’s disease (PD) population. Methods: Total six English and Chinese databases were searched for articles published up to May 2021. Randomized controlled trials (RCTs) evaluating mind–body excises on non-motor symptoms of PD were included. The Cochrane risk of bias tool was used to assess the methodological quality, and we defined high-quality studies as having a low risk of bias in four or more domains. Global cognitive function was considered the primary outcome and was assessed using the Montreal Cognitive Assessment (MoCA). The secondary outcomes included QOL, fatigue, depression, and sleep quality, which were measured using the Parkinson’s Disease Questionnaire (PDQ-39), 16-item Parkinson’s Disease Fatigue Scale (PFS-16), Beck Depression Inventory (BDI), and revised Parkinson’s Disease Sleep Scale (PDSS-2), respectively. Subgroup analyses were conducted for global cognitive function and QOL to assess the optimal treatment measure across the various mind–body exercises. Results: Fourteen RCTs with 404 patients were finally included in the meta-analysis. Eight (57.14%) studies were of high quality. The pooled results showed that mind–body exercises generally had a significant advantage over the control intervention in improving global cognitive function (MD = 1.68; P = 0.0008). The dose subgroup analysis revealed that the low dose (60–120 min per week) and moderate dose (120–200 min per week) significantly increased MoCA scores compared with the control group (MD = 2.11, P = 0.01; MD = 1.27, P = 0.02, respectively). The duration subgroup analysis indicated a significant difference in the effect of the duration (6–10 and >15 weeks) on increasing MoCA scores compared with the control group (MD = 3.74, P < 0.00001; MD = 1.45, P = 0.01, respectively). Conclusion: Mind–body exercise may improve global cognitive function, sleep quality, and QOL in the PD population. In addition, low to moderate doses and appropriate durations significantly improved global cognitive function. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [CRD42021275522].
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Affiliation(s)
- Kai Wang
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Kunbin Li
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
- *Correspondence: Kunbin Li,
| | - Peiming Zhang
- Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuqi Ge
- Department of Rehabilitation, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, China
| | - Xiaopeng Wen
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Zhiyuan Wu
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Xianli Yao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Bing Jiao
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Pingge Sun
- Department of Neurological Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Peipei Lv
- Department of Medical Imaging, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Liming Lu
- Clinical Research and Data Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Liming Lu,
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Characterization of dance-based protocols used in rehabilitation - A systematic review. Heliyon 2021; 7:e08573. [PMID: 34977404 PMCID: PMC8683737 DOI: 10.1016/j.heliyon.2021.e08573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/04/2021] [Accepted: 12/06/2021] [Indexed: 12/04/2022] Open
Abstract
Objective To describe the use of dance-based intervention protocols as a rehabilitation proposal. Method Papers containing protocols used in adult patients and written in Spanish, English, and Portuguese were collected using the following keywords: Physical Therapy; Dance Therapy; Rehabilitation; and Clinical Trial Protocol. The PUBMED, MEDLINE, LILACS, BVS ScienceDirect, PEDro, OTseeker, The Cochrane Library (Cochrane Central Register of Controlled Trials), and Scopus databases were used for the collection of information to define the type of dance, the established protocol, pathologies, and the population involved. Results 70 studies met the eligibility criteria, all of which presented a dance protocol. This was used in the rehabilitation of pathologies covering the neuromuscular, musculoskeletal, and cardiovascular systems, as well as in a healthy population. Positive results were the main outcome measure. Discussion Dance is an innovative intervention strategy for patients with comorbidities or underlying pathologies as well as for those in good health. It offers, without limitations, a field of applicability through the use of a dancing style as a rehabilitation process, generating significant changes in the physical, mental, and social skills of the individual.
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Delfa-Lobato L, Guàrdia-Olmos J, Feliu-Torruella M. Benefits of Cultural Activities on People With Cognitive Impairment: A Systematic Review. Front Psychol 2021; 12:762392. [PMID: 34899506 PMCID: PMC8656402 DOI: 10.3389/fpsyg.2021.762392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Museums and cultural institutions are increasingly striving to respond to the interests and needs of the society that hosts them. This means, apart from other actions, that these institutions must be involved in the health and wellbeing of society, and the creation of cultural activities aimed at people with cognitive impairment, a group of individuals that is growing worldwide due to the aging of society and the increasing prevalence of dementia. The involved sectors are aware of the potential and benefits of activities for this population, even though there is much research to be conducted. To date, no systematic review has focused on the benefits of cultural activities for cognitively impaired people. This study aimed to explore the benefits of different modalities of cultural activities with evidence from 145 studies from various databases, which met the inclusion criteria. Significant improvements in general cognition, quality of life (QoL), emotional wellbeing, socialization, and communication were generally reported after interventions, with a reduction in depression symptoms. There was not enough evidence to prove memory, language, or daily functioning improvements attributable to cultural interventions. There were no significant reductions reported in apathy, sadness, agitation, or anxiety.
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Affiliation(s)
- Laia Delfa-Lobato
- Faculty of Geography and History, University of Barcelona, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- UB Institute of Complex Systems, University of Barcelona, Barcelona, Spain
| | - Maria Feliu-Torruella
- Department of Applied Didactics, Faculty of Education, University of Barcelona, Barcelona, Spain
- Institute of Research in Education (IRE), University of Barcelona, Barcelona, Spain
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Dance and Music for Improving Health among Patients with Breast Cancer and Parkinson’s Disease: A Narrative Review. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although a longer life may bring new opportunities for older people and society, advancing age is a leading risk factor for developing several chronic diseases, consequently limiting the health span. During the ageing process, changes in the activity of several endocrine glands may occur, leading to different clinical conditions. Being physically active becomes fundamental for healthy ageing. Despite regular physical activity being shown to have many health benefits, patients with cancer and neurodegenerative diseases remain physically inactive. Over the past two decades, there has been a major increase in arts engagement (e.g., dance and music) on health and well-being in both clinical and non-clinical contexts. Dance and music have been shown to induce positive effects on hormonal glands, patients’ sociality, and self-confidence. Therefore, this review aims to highlight evidence regarding the effects of music and dance on hormonal responses and as preventive and compliance tools for heathy ageing in breast cancer and Parkinson’s disease patients.
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Emmanouilidis S, Hackney ME, Slade SC, Heng H, Jazayeri D, Morris ME. Dance Is an Accessible Physical Activity for People with Parkinson's Disease. PARKINSON'S DISEASE 2021; 2021:7516504. [PMID: 34721836 PMCID: PMC8556098 DOI: 10.1155/2021/7516504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/16/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the outcomes of face-to-face, digital, and virtual modes of dancing for people living with Parkinson's disease (PD). DESIGN Systematic review informed by Cochrane and PRIMSA guidelines. Data Sources. Seven electronic databases were searched: AMED, Cochrane, PEDro, CINHAL, PsycINFO, EMBASE, and MEDLINE. METHODS Eligible studies were randomised controlled trials (RCT) and other trials with quantitative data. The PEDro scale evaluated risk of bias for RCTs. Joanna Briggs Institute instruments were used to critically appraise non-RCTs. The primary outcome was the feasibility of dance interventions, and the secondary outcomes included gait, balance, quality of life, and disability. RESULTS The search yielded 8,327 articles after duplicates were removed and 38 met the inclusion criteria. Seven were at high risk of bias, 20 had moderate risk of bias, and 11 had low risk of bias. There was moderately strong evidence that dance therapy was beneficial for balance, gait, quality of life, and disability. There was good adherence to digital delivery of dance interventions and, for people with PD, online dance was easy to access. CONCLUSION Dancing is an accessible form of exercise that can benefit mobility and quality of life in people with PD. The COVID-19 pandemic and this review have drawn attention to the benefits of access to digital modes of physical activity for people living with chronic neurological conditions.
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Affiliation(s)
- Sara Emmanouilidis
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Madeleine E. Hackney
- Emory University School of Medicine, Department of Medicine, Division of Geriatrics and Gerontology, Atlanta, USA
- Atlanta Veterans Affairs Centre for Visual & Neurocognitive Rehabilitation, Decatur, GA, USA
| | - Susan C Slade
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Hazel Heng
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Dana Jazayeri
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
| | - Meg E. Morris
- Academic and Research Collaborative in Health, La Trobe University, Bundoora, Victoria, Australia
- Victorian Rehabilitation Centre, Glen Waverley, Victoria, Australia
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