Vigorous Aerobic Exercise in the Management of Parkinson Disease: A Systematic Review

Objective To summarize the findings from studies examining the effects of vigorous-intensity aerobic exercise in the management of Parkinson disease. Type Systematic review. Literature Survey PubMed/MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ScienceDirect databases were searched up to May 2020. Reference lists of the included articles were also searched for additional studies. Searches were restricted to English language. Methodology Seven papers, including six studies, five randomized controlled trials and one controlled trial, were identified. The studies examined the effects of vigorous-intensity aerobic exercise in participants with Parkinson disease. Studies in which the minimal intensity required was >= 77% of maximum heart rate, 60% of heart rate reserve or 64% of maximal oxygen uptake met the inclusion criteria. Method appraisal showed a mean score of 5.3 in the Physiotherapy Evidence Database (PEDro) scale. Synthesis No statistically significant differences were found between vigorous-intensity aerobic exercise and moderate/low-intensity aerobic exercise for the main outcomes (disease severity and motor function). Only one study concluded a significant higher aerobic fitness in favor of the group that exercised at vigorous intensity compared to the moderate intensity group. Conclusions Vigorous-intensity aerobic exercise has not shown statistically significant improvements in motor and nonmotor impairments in individuals with Parkinson disease as compared to moderate/low-intensity aerobic exercise. Hence, the current evidence is too limited to allow recommendations for clinical practice.

Automated summary

Studies examining the effects of vigorous-intensity aerobic exercise in Parkinson disease management did not find statistically significant differences compared to moderate/low-intensity aerobic exercise. Only one study showed a significant improvement in aerobic fitness for the vigorous intensity group, but overall evidence is too limited to make recommendations for clinical practice.