Effects of Aerobic Exercise and Mind-Body Exercise in Parkinson’s Disease: A Mixed-Treatment Comparison Analysis

Background/Objectives: Aerobic exercise and mind-body exercise, are vital for improving motor and non-motor functional performance of Parkinson’s disease (PD). However, evidence-based recommendations on which type of exercise is most suitable for each individual are still lacking. Therefore, we conduct a network meta-analysis to assess the relative efficacy of aerobic and mind-body exercise on motor function and non-motor symptoms in Parkinson’s disease and to determine which of these therapies are the most suitable.Design: A network meta-analysis and dose-response analysis.Setting and Participants: Medline, Embase (all via Ovid), and the Cochrane Central Register of Controlled Trials were comprehensively searched for related trials through April 2021.Measurements: Study quality was evaluated using the Cochrane Risk of Bias Tool. The effect sizes of continuous outcomes were calculated using mean differences (MDs) or standardized mean differences (SMDs). A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of the therapies. The dose-response relationship was determined based on metaregression and SUCRA.Results: Fifty-two trials with 1971 patients evaluating six different therapies were identified. For the UPDRS-motor score and TUG score, yoga all ranked highest (SUCRA = 92.8%, 92.6%, respectively). The SUCRA indicated that walking may best improve the BBS score (SUCRA = 90.2%). Depression, cognitive and activities of daily living scores were significantly improved by yoga (SUCRA: 86.3, 95.1, and 79.5%, respectively). In the dose-response analysis, 60-min sessions, two times a week might be the most suitable dose of yoga for reducing the UPDRS-motor score of PD patients.Conclusion: Yoga and walking are important options for increasing functional mobility and balance function, and yoga might be particularly effective for decreasing depressive symptoms and cognitive impairment and improving activities of daily living in PD. The potential optimal dose of yoga for enhancing motor ability in PD patients is 60-min sessions, two times a week.Registration: PROSPERO CRD42021224823.

Download Full-text

UPDRS motor-score improvement after CVT-301 treatment is associated with improved scores in Parkinson's Disease Questionnaire (PDQ-39) activities of daily living

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2020.06.250 ◽

2020 ◽

Vol 79 ◽

pp. e68

Author(s):

R.A. Hauser ◽

M. Klingler ◽

I. Abeynayake ◽

H. Roberts

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Motor Score ◽

Score Improvement ◽

Disease Questionnaire ◽

Parkinson’S Disease Questionnaire ◽

Updrs Motor Score

Download Full-text

Rehabilitation training based on virtual reality for patients with Parkinson’s disease in improving balance, quality of life, activities of daily living, and depressive symptoms: A systematic review and meta-regression analysis

Clinical Rehabilitation ◽

10.1177/0269215521995179 ◽

2021 ◽

pp. 026921552199517

Author(s):

Runze Li ◽

Yanran Zhang ◽

Yunxia Jiang ◽

Mengyao Wang ◽

Wei How Darryl Ang ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Virtual Reality ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Daily Living ◽

Meta Analysis ◽

Rehabilitation Training

Objective: To examine the effectiveness of rehabilitation training based on virtual reality in improving balance, quality of life, activities of daily living, and depressive symptoms of patients with Parkinson’s disease. Data sources: PubMed, EMBASE, CINAHL, Scopus, Cochrane Library, PsycINFO, ProQuest, Physiotherapy Evidence Database, IEEE Xplore, China National Knowledge Infrastructure, Wanfang, and VIP Information databases were searched from their inception to October 15, 2020. Trial registries, gray literature, and target journals were also searched. Methods: Eligible randomized controlled trials included studies with patients with Parkinson’s disease in rehabilitation training based on virtual reality. Comprehensive Meta-Analysis 3.0 software was used. Physiotherapy Evidence Database Scale and the Grading of Recommendation, Assessment, Development, and Evaluation system were used to assess the methodological quality of individual trials and the overall quality of the evidence, respectively. Results: A total of 22 randomized controlled trials with 836 patients were included. Meta-analysis revealed that training significantly improved balance ( g = 0.66, P < 0.001), quality of life ( g = 0.28, P = 0.015), activities of daily living ( g = 0.62, P < 0.001), and depressive symptoms ( g = 0.67, P = 0.021) compared to the control group. Subgroup analysis indicated that training should utilize video game consoles. Meta-regression analyses showed that age, sessions, and frequency of training had statistically significant impacts on balance scores. Quality of individual trials was high and overall evidence ranged from very low to low. Conclusion: Virtual rehabilitation training could be adopted in healthcare institutions as supplementary training for patients with Parkinson’s disease.

Download Full-text

Impact of carbidopa-levodopa enteral suspension on quality of life and activities of daily living in patients with advanced Parkinson's Disease: Results from a pooled meta-analysis

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2021.03.009 ◽

2021 ◽

Author(s):

David G. Standaert ◽

Vardhaman Patel ◽

Sonya J. Snedecor ◽

Sandeep Thakkar ◽

Yash J. Jalundhwala ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Meta Analysis ◽

Advanced Parkinson’S Disease

Download Full-text

Parkinson's Disease Risk and Alcohol Intake: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies

Frontiers in Nutrition ◽

10.3389/fnut.2021.709846 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chuan Shao ◽

Xiaoya Wang ◽

Pan Wang ◽

Hui Tang ◽

Jiaquan He ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dose Response ◽

Prospective Studies ◽

Alcohol Intake ◽

Meta Analysis ◽

Alcohol Exposure ◽

Geographic Area ◽

Alcoholic Beverages ◽

Response Analysis

Background: The association between Parkinson's disease (PD) risk and alcohol intake is a controversial topic.Objectives: To systematically assess the association between PD risk and alcohol intake.Methods: PubMed and Embase databases were searched for eligible studies with prospective design on PD risk and alcohol intake. A meta-analysis with a random-effects model and dose-response analysis was performed. Relative risk ratios (RRs) with 95% CIs were calculated.Results: Eleven prospective studies were included. Overall, a higher intake of alcohol was inversely associated with PD risk (RR: 0.81, 95% CI: 0.70–0.95, I2 = 73.7%). Significant differences existed between the specific types of alcoholic beverages and geographic area. Specifically, a significant association existed for beer (RR: 0.78, 95% CI: 0.65–0.94, I2 = 0.0%) and studies conducted in Asia (RR: 0.66, 95% CI: 0.55–0.80, I2 = 37.3%). Dose-response analysis indicated a nonlinear relationship between PD risk and alcohol exposure. No evidence for publication bias was detected.Conclusions: In summary, our meta-analysis suggests that alcohol consumption was associated with a decreased risk of PD, with a nearly U-shaped association. Future studies are warranted to clarify the question of a specific type of alcoholic beverage-dependent association, geographic area effect, and possible threshold effects regarding both the adverse and beneficial effects of alcohol.

Download Full-text

Deep brain stimulation for Parkinson’s disease: meta-analysis of results of randomized trials at varying lengths of follow-up

Journal of Neurosurgery ◽

10.3171/2016.11.jns16715 ◽

2018 ◽

Vol 128 (4) ◽

pp. 1199-1213 ◽

Cited By ~ 24

Author(s):

Alireza Mansouri ◽

Shervin Taslimi ◽

Jetan H. Badhiwala ◽

Christopher D. Witiw ◽

Farshad Nassiri ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Activities Of Daily Living ◽

Brain Stimulation ◽

Daily Living ◽

Meta Analysis ◽

Stn Dbs ◽

Deep Brain

OBJECTIVEDeep brain stimulation (DBS) is effective in the management of patients with advanced Parkinson’s disease (PD). While both the globus pallidus pars interna (GPi) and the subthalamic nucleus (STN) are accepted targets, their relative efficacy in randomized controlled trials (RCTs) has not been established beyond 12 months. The objective of this study was to conduct a meta-analysis of RCTs to compare outcomes among adults with PD undergoing DBS of GPi or STN at various time points, including 36 months of follow-up.METHODSThe MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases were searched. Registries for clinical trials, selected conference proceedings, and the table of contents for selected journals were also searched. Screens were conducted independently and in duplicate. Among the 623 studies initially identified (615 through database search, 7 through manual review of bibliographies, and 1 through a repeat screen of literature prior to submission), 19 underwent full-text review; 13 of these were included in the quantitative meta-analysis. Data were extracted independently and in duplicate. The Cochrane Collaboration tool was used to assess the risk of bias. The GRADE evidence profile tool was used to assess the quality of the evidence. Motor scores, medication dosage reduction, activities of daily living, depression, dyskinesias, and adverse events were compared. The influence of disease duration (a priori) and the proportion of male patients within a study (post hoc) were explored as potential subgroups.RESULTSThirteen studies (6 original cohorts) were identified. No difference in motor scores or activities of daily living was identified at 36 months. Medications were significantly reduced with STN stimulation (5 studies, weighted mean difference [WMD] −365.46, 95% CI −599.48 to −131.44, p = 0.002). Beck Depression Inventory scores were significantly better with GPi stimulation (3 studies; WMD 2.53, 95% CI 0.99–4.06 p = 0.001). The motor benefits of GPi and STN DBS for PD are similar.CONCLUSIONSThe motor benefits achieved with GPi and STN DBS for PD are similar. DBS of STN allows for a greater reduction of medication, but not as significant an advantage as DBS of GPi with respect to mood. This difference is sustained at 36 months. Further long-term studies are necessary.

Download Full-text

Open-Label Study With Pimavanserin on Activities of Daily Living in Subjects With Parkinson's Disease Psychosis

Case Medical Research ◽

10.31525/ct1-nct04292223 ◽

2020 ◽

Author(s):

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Open Label ◽

Open Label Study ◽

Label Study

Download Full-text

Analysis of Functional and Cognitive Impairment in Institutionalized Individuals with Movement Disorders

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190311104247 ◽

2019 ◽

Vol 19 (7) ◽

pp. 1022-1031 ◽

Cited By ~ 2

Author(s):

Paula D. Cebrián ◽

Omar Cauli

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Activities Of Daily Living ◽

Cognitive Performance ◽

Functional Impairment ◽

Movement Disorders ◽

Neurological Disorders ◽

Daily Living ◽

Severe Cognitive Impairment

Background: Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. Objective: We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson’s disease, Alzheimer’s disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. Methods: All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. Results: The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson’s disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. Conclusion: In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.

Download Full-text