Resistance training (RT) may help improve several Parkinson’s disease (PD) symptoms, but is not superior to other physical activities, new research suggests.
A meta-analysis, which included 18 randomized controlled trials and over 1000 patients with PD, showed that those undergoing RT had significantly greater improvement in motor impairment, muscle strength, and mobility/balance than their peers undergoing passive or placebo interventions. .
However, there was no significant difference between patients who participated in RT and those who participated in other active physical interventions, including yoga.
Overall, the results highlight the importance that these patients should participate in some type of exercise, the study’s lead author, Romina Gollan, MSc, assistant researcher, Department of Medical Psychology, University of Cologne, Germany, said. Medscape Medical News. “Patients should definitely do exercise, including resistance training, if they want to, but the type of exercise is secondary,” she said.
The findings were presented at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2022.
Positive but inconsistent
Previous reviews have suggested that RT has positive effects on motor function in PD. However, the results of the included studies were inconsistent; and few reviews have examined non-motor outcomes of RT in this population, the researchers note.
After a literature review of studies examining the effects of RT in PD, the researchers included 18 randomized controlled trials in their current review. Of the 1134 total participants, the mean age was 66 years, the mean Hoehn & Yahr stage 2.3 (range 0-4), and the mean duration of PD was 7.5 years.
The study was grouped into two meta-analysis groups: one assessed RT versus a passive or placebo intervention and the other assessed RT versus active physical interventions, such as yoga.
During RT, participants use their full strength to do a repetition, working muscles to overcome a certain threshold, Gollan said. In contrast, a placebo intervention is “very low intensity” and involves a much lower threshold, she added.
Passive interventions include things like stretching where the stimulus is “not high enough for muscles to adapt” and building strength, Gollan noted.
A passive intervention may also include “treatment as usual” or normal daily routines.
Patient Preference Important
The meta-analysis comparing RT groups with passive control groups showed significant large effects on muscle strength (standard mean difference [SMD], -0.84; 95% CI, -1.29 to -0.39; p = .0003), motor impairment (SMD, -0.81; 95% CI, -1.34 to -0.27; p = 0.003) and mobility and balance (SMD, -1.80; 95% CI, -3.13 to -0.49; p = .007).
The review also showed significant but small effects on quality of life.
However, the meta-analysis assessing RT versus other physical interventions showed no significant differences between groups.
Gollan noted that while there were some assessments of cognition and depression, the data was too limited to determine the impact of RT on these results.
“We need more studies, especially randomized controlled trials, to investigate the effects of RT on non-motor outcomes such as depression and cognition,” she said.
Co-researcher Ann-Kristin Folkerts, PhD, head of the Medical Psychology Working Group at the University of Cologne, noted that while exercise is generally beneficial for patients with PD, the choice of activity should take preferences into account. of the patient.
It’s important for patients to choose an exercise they enjoy “because otherwise they probably wouldn’t stick to the treatment,” Folkerts said. Medscape Medical News. “It’s important to have fun.”
Specific goals or objectives, such as improving quality of life or balance, should also be considered, she added.
Respond Medscape Medical NewsAlice Nieuwboer, PhD, professor in the Department of Rehabilitation Sciences and head of the Neurorehabilitation Research Group at the University of Leuven, Belgium, disagreed that the type of exercise is of secondary importance in PD.
“In my opinion, it’s of primary importance, especially in the mid-to-late stages,” said Nieuwboer, who was not involved in the study.
She noted that it is difficult to conduct meta-analyses of RT versus other interventions because studies comparing different types of exercise “are quite scarce.”
“Another point is that the dosage can differ, so you’re comparing apples to oranges,” says Nieuwboer.
She did agree that all patients should exercise, because it is “better than not exercising”, and that they should be “free to choose a mode that interests them”.
However, she emphasized that exercise requires significant effort from patients with PD, requires “sustained motivation,” and must become habit-forming. This makes “targeted training” very important, with the goal changing over the course of the disease, Nieuwboer said.
For example, for a patient in an early stage of the disease who can still move quite well, both RT and endurance training can improve fitness and health; but halfway through, it may be better for patients to work on balance and walking quality “to avoid the risk of falls and frostbite,” she noted.
Later, when exercise becomes very difficult, “the exercise menu is even more limited,” Nieuwboer said.
The bottom line is that a message that reads “every move counts” is too much of a simplification, she added.
The study was funded by a grant from the German Federal Ministry of Education and Research. The investigators and Nieuwboer have not reported any relevant financial relationships.
International Congress on Parkinson’s Disease and Movement Disorders (MDS) 2022: Executive Summary 237. Presented September 15, 2022.
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