ABSTRACT
Introduction: Parkinson's disease is a movement disorder that also manifests non-motor symptoms (NMS). Physical exercise is a prominent strategy that can have an impact on NMS; however, the evidence is limited. Our aim was to verify the effects of exercise on NMS, as assessed using general NMS scales. Methods: This study is a systematic review and meta-analysis. Two searches were conducted on the PubMed, Cochrane Library, Scopus, Web of Science, Embase, Science Direct and PEDro databases from September to December 2022. The PEDro scale was used to assess the methodological quality of the studies. Results: Twenty-three studies were included. The interventions were classified as multimodal, aerobic, resistance, dance, conventional physical therapy and other types. Five studies had high risk of bias. Eight studies were included in the meta-analyses. According to the criteria, four studies compared exercise with non-exercise (n=159), two compared multimodal exercise with cognitive/leisure approaches (n=128), and two compared aerobic with conventional exercise (n=40). No statistical differences were observed between exercise and non-exercise (-0.26 (-0.58 to 0.05)) and between multimodal and cognitive approaches (0.21 (-0.14 to 0.55)). However, trends were observed in the direction of exercise and cognitive approaches. A significant difference was observed favouring aerobic over conventional exercise (-0.72 (-1.36 to -0.08)). Conclusions: Our findings suggest that exercise may have an effect on general NMS compared with non-exercise, although only a trend was observed. It was also observed for cognitive approaches over multimodal exercises. Aerobic exercise showed near-large effects compared with conventional exercise.
ABSTRACT
BACKGROUND: Older adults are benefited from the continuous tactile information to enhance postural control. Therefore, the aim was to evaluate the effect of the haptic anchors during balancing and walking tasks in older adults. METHODS: The search strategy (up to January 2023) was based on the PICOT (older adults; anchor system during balance and walking tasks; any control group; postural control measurements; short and/or long-term effect). Two pairs of reviewers independently examined all titles and abstracts for eligibility. The reviewers independently extracted data from the included studies, assessed the risk of bias, and certainty of the evidence. RESULTS: Six studies were included in the qualitative synthesis. All studies used a 125-g haptic anchor system. Four studies used anchors when standing in a semi-tandem position, two in tandem walking on different surfaces, and one in an upright position after plantar flexor muscle fatigue. Two studies showed that the anchor system reduced body sway. One study showed that the ellipse area was significantly lower for the 50% group (reduced frequency) in the post-practice phase. One study showed that the reduction in the ellipse area was independent of the fatigue condition. Two studies observed reduced trunk acceleration in the frontal plane during tandem waking tasks. The studies had low to moderate certainty of evidence. CONCLUSION: Haptic anchors can reduce postural sway during balance and walking tasks in older adults. Also, positive effects were seen during the delayed post-practice phase after the removal of anchors only in individuals who used a reduced anchor frequency.
