Optimal dose and type of exercise improve the overall balance in adults with Parkinson’s disease: a systematic review and Bayesian network meta-analysis

作者：Xianjin Fan, Yuan Yuan, Ying Bai, Cheng Chen, Junyu Wang, Tao Wang, Yong Yang, Ko-Chia Chen · 发表于：Neurological Sciences · 年份：2025 · DOI：10.1007/s10072-025-08244-1 · 被引用次数：9 · 研究领域：Balance, Gait, and Falls Prevention、Parkinson's Disease Mechanisms and Treatments、Parkinson's Disease and Spinal Disorders

OBJECTIVE: To investigate the dose-response relationship between various exercise modalities and their effectiveness in enhancing balance in Parkinson's disease (PD) patients. METHODS: Searches were conducted in PubMed, Medline, Embase, PsycINFO, Cochrane Library, and Web of Science from inception to July 23th, 2024. Data were analyzed using R software, with the MBNMA and RJAGS packages to compute standardized mean differences (SMD) and 95% credible intervals (95% CrI). The network's risk of bias was rigorously evaluated by two independent reviewers using the ROB2 tool. RESULTS: The analysis included 73 studies with 3,747 PD patients, assessing the effects of different exercises on balance. The findings demonstrate a nonlinear increasing dose-response relationship. Dance was the most effective, with an optimal dose of 1000 METs-min/week, closely followed by aerobic exercise (AE) at 1200 METs-min/week. Aquatic exercise (AQE), multicomponent exercise (MulC), and sensory exercise (SE) exhibited an inverted U-shaped response, with peak improvements at 700 METs-min/week for AQE, 610 METs-min/week for MulC, and 620 METs-min/week for SE. Balance and gait training (BGT), mind-body exercise (MBE), and resistance training (RT) also significantly improved balance, with optimal dosages below 750 METs-min/week. CONCLUSION: Specific exercises, particularly dance at 1000 METs-min/week, significantly enhance balance in PD patients. Nonlinear dose-response patterns and inverted U-shaped curve...