Resistance training is associated with improvements in Parkinson’s disease symptoms

Resistance training (RT) can help improve many symptoms of Parkinson’s disease (PD) – but not superior to other physical activities, according to new research.

The meta-analysis, which included 18 randomized controlled trials and more than 1,000 patients with Parkinson’s, showed that those who underwent blunt treatment had significant improvement in motor impairment, muscle strength, and mobility/balance compared to peers who underwent 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.


Romina Golan

Overall, the findings highlight the importance of these patients participating in some kind of physical exercise, said lead author of the study, Romina Golan, MA, research assistant, Department of Medical Psychology, University of Cologne, Germany, Medscape Medical News. “Patients should definitely do exercises, including resistance training, if they want to. But the type of exercise is of secondary importance,” she said.

The Results are displayed At the International Conference on Parkinson’s Disease and Movement Disorders (MDS) 2022.

Positive but inconsistent

Previous reviews suggested that radiotherapy has positive effects on motor function in Parkinson’s disease. However, the results of the included studies were inconsistent. The investigators note that few reviews have examined the non-kinetic outcomes of RT in this population.

After conducting a literature search for studies that examined the effects of RT in Parkinson’s, the researchers included 18 randomized controlled trials in their current review. Of the total 1134 participants, the mean age was 66 years, the mean Hoehn & Yahr stage was 2.3 (range 0–4), and the median duration of PD was 7.5 years.

The investigation was grouped into two meta-analysis groups: one examining RT against a passive or placebo intervention, and the other assessing RT against active physical interventions, such as yoga.

During the psychotherapy period, participants use their full strength to perform repetitions of working muscles to overcome a certain threshold, Golan said. By contrast, she added, the placebo intervention is “extremely low-intensity” and has a much lower threshold.

Golan noted that passive interventions include things like stretching where the stimulus is “not loud enough for the muscles to adapt” and building strength.

Passive intervention may also include ‘treatment as usual’ or a normal daily routine.

Patient preference is important

A meta-analysis comparing the RT groups with negative control groups showed significant significant effects on muscle strength (standard mean difference [SMD], -0.84; 95% CI, -1.29 to -0.39; s = .0003), motor impairment (SMD, -0.81; 95% CI, -1.34 to -0.27; s = .003), mobility and balance (SMD, -1.80; 95% CI, -3.13 to -0.49; s = .007).

The review also showed significant but small effects on quality of life.

However, a meta-analysis that evaluated RT versus other physical interventions showed no significant between-group differences.

Golan notes that although there are some assessments of perception and depressionthe data were too limited to determine the effect 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.



Dr. Anne Kristen Folkerts

Co-researcher Anne-Christine Volkerts, MD, who chairs the Working Group on Medical Psychology at the University of Cologne, noted that although exercise is generally beneficial for Parkinson’s patients, the choice of activity should take into account the patient’s preferences.

Volkert said it’s important for patients to choose an exercise they enjoy “otherwise they won’t stick to the treatment.” Medscape Medical News. “It is important that you have fun.”

She added that specific goals or objectives, such as improving quality of life or balance, should also be considered.

Oversimplification?

Comment on Medscape Medical NewsAlice Neubauer, PhD, professor in the Department of Rehabilitation Sciences and chair 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 view, they are of fundamental importance, especially in the middle to later stages,” said Newport, who was not involved in the research.

She noted that it is difficult to perform meta-analyses of RT versus other interventions because studies comparing different types of exercise are “rarely scarce.”

“Another issue is that the dosage may vary, so you’re comparing apples to pears,” Newport said.

She agreed that all patients should exercise, as it is “better than no exercise”, and should be “free to choose the position that interests them”.

She stressed, however, that exercise requires significant effort on the part of Parkinson’s patients, requires “sustained motivation”, and must become a habit. This makes “exercise targeting” so important, Neubauer said, with the target changing during the course of the disease.

For example, for a patient in an early stage of the disease who can still move well, both RT and endurance training can improve fitness and health; She noted that in the middle of the stage, it may be best for patients to work on balance and gait quality “to avoid the risk of falls and the development of freezing.”

Later, when movement becomes too difficult, “the exercise menu becomes more restrictive,” Neubauer said.

The bottom line, she added, is that the message “any movement is significant” is an oversimplification.

The study was funded by a grant from the German Federal Ministry of Education and Research. Investigators and Nieuwboer reported no relevant financial relationships.

International Conference on Parkinson’s Disease and Movement Disorders (MDS) 2022: Summary 237. It was submitted on September 15, 2022.

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