The effect of home-based exercise on motor symptoms, quality of life and functional performance in Parkinson's disease: a systematic review and meta-analysis

• Published in: BMC geriatrics Vol. 23; no. 1; p. 873
• Main Authors: Yang, Yong, Fu, Xueying, Zhang, Haoyang, Ouyang, Guoguang, Lin, Shu-Cheng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19-12-2023; BioMed Central; BMC
• Subjects: Accidental Falls; Analysis; Care and treatment; Coronaviruses; COVID-19; Diagnosis; Exercise; Exercise therapy; Exercise Therapy - methods; Fear; Fingers; Health aspects; Home-based exercise; Humans; Medical research; Medicine, Experimental; Meta-analysis; Motor Skills; Motor symptoms; Movement disorders; Neurodegenerative diseases; Older people; Parkinson Disease - diagnosis; Parkinson Disease - therapy; Parkinson's disease; Parkinson's disease patients; Patient outcomes; Physical activity; Physical fitness; Physical Functional Performance; Physical training; Physiological aspects; Quality of Life; Walking; Taiwan; COVID-19; Home-based exercise; Physical activity; Parkinson's disease patients; Motor symptoms
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-023-04595-6

Faced with the lack of physical activity caused by mandatory home isolation during special periods and patients' inconvenience in carrying out professionally supervised exercise, many home-based exercise programs have been developed. This systematic review and meta-analysis aimed to examine the effects of home-based exercise on measures of motor symptoms, quality of life and functional performance in Parkinson's disease (PD) patients.
We performed a systematic review and meta-analysis, and searched PubMed, MEDLINE, Embase, Cochrane library, and Web of Science from their inception date to April 1, 2023. The quality of the literature was assessed using PEDro's quality scale. The data was pooled using R software. Results are presented as pooled standardized mean difference (SMD) with 95% confidence interval (CI).
A total of 20 studies involving 1885 PD patients were included. Meta-analysis results showed that home-based exercise had a small effect in relieving overall motor symptoms in PD patients (SMD = -0.29 [-0.45, -0.13]; P < 0.0001), improving quality of life (SMD = 0.20 [0.08, 0.32]; P < 0.0001), walking speed (SMD = 0.26 [0.05, 0.48]; P = 0.005), balance ability (SMD = 0.23 [0.10, 0.36]; P < 0.0001), finger dexterity (SMD = 0.28 [0.10, 0.46]; P = 0.003) and decreasing fear of falling (SMD = -0.29 [-0.49, -0.08]; P = 0.001). However, home-based exercise did not significantly relieve the overall motor symptoms of PD patients when the training period was less than 8 weeks and the total number of sessions was less than 30.
During times of limited physical activity due to pandemics such as COVID-19, home-based exercise is an alternative to maintain and improve motor symptoms in PD patients. In addition, for the minimum dose of home-based exercise, we recommend that the exercise period is no less than 8 weeks and the total number of sessions is no less than 30 times.
PROSPERO registration number: CRD42022329780.