masterThesis
Ejercicio y resultados clínicos en pacientes con enfermedad de Parkinson: una revisión sistemática y metaanálisis
Fecha
2015Autor
Reyes, Alexander
Institución
Resumen
Background: Parkinson is the second most common neurodegenerative disease
worldwide. Physical exercise has been considered as an effective non
pharmacological strategy to improve functional impairment in patients with
Parkinson.
Objective: To determine the effects of the different modalities of physical exercise
on the main clinical related outcomes in patients with Parkinson Disease (PD).
Methods: MEDLINE, EMBASE, Scopus, CENTRAL and PEDro databases were
searched up since February 1990 to February 2014 to identify randomized
controlled trials (RTC’s). Further, reference lists and others related reviews were
also checked. Data extraction was conducted by two independent authors. A
random-effects model of meta-analysis was undertaken in presence of statistical
heterogeneity (I2>50%). Publication bias was estimated using a funnel plot and the
Egger’s test (p<0.05).
Results: A total of 18 studies were included. Physical exercise produced
significant improvements on motor symptoms severity (MDS-UPDRS) (SMD=
1.44, 95% CI -2.09 to -0.78; p<0.001) (I2= 87.9%) and balance (SMD= 0.52, 95%CI
0.30 to 0.74; p<0.001) (I2= 85.6%). In the subgroup analyses, aerobic exercise
produced significant benefits on motor symptoms severity (SMD= -1.28, 95%CI
1.98 to -0.59; p<0.001), quality of life (SMD= -1.91, 95%CI -2.76 to -1.07;
p<0.001), balance (SMD= 0.54, 95%CI 0.31 to 0.77; p<0.001), Vo2 max (SMD=
1.09, 95%CI -1.31 to -0.88; p=0.001) and 6 minutes walking test (SMD= 40.46,
95%CI 11.28 to 69.65; p=0.007).
Conclusion: Aerobic exercise improves motor symptoms severity, balance, quality
of life and aerobic capacity in patients with PD. Resistance training provides
benefits on the muscular strength of these patients.