Which exercise intervention is most promising for Parkinson's balance? A network meta-analysis

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Gerontology

Background:

• Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms and balance impairments.
• Balance deficits in PD increase fall risk and reduce quality of life.
• Exercise is a key non-pharmacological intervention, but optimal modalities require clarification.

Purpose of the Study:

• To conduct a network meta-analysis comparing the efficacy of various exercise therapies on balance outcomes in Parkinson's disease (PD) patients.
• To provide evidence-based guidance for exercise prescription in PD management.
• To identify the most effective exercise modalities for improving balance and motor function in PD.

Main Methods:

• Systematic search of multiple databases (PubMed, EMBASE, Cochrane Library, Web of Science, CNKI) up to August 2025.
• Inclusion and exclusion criteria screening of relevant literature.
• Network meta-analysis comparing 30 different exercise interventions across 135 articles involving 5948 PD patients.

Main Results:

• Dance exercise (DE) significantly improved Berg Balance Scale (BBS) scores compared to control (CON) and Traditional Rehabilitation (TR).
• Biofeedback Balance and Gait Training (BGT) superiorly reduced Timed Up and Go Test (TUG) scores versus CON, TR, Stretch exercise (SE), Virtual Reality Balance Training (VRB), and Yoga (YG).
• Pilates exercise (PE) and Qigong (QG) demonstrated significant improvements in Unified Parkinson's Disease Rating Scale III (UPDRS-III) scores compared to CON and/or TR, RT.

Conclusions:

• DE and BGT show superior efficacy in improving balance function in PD patients compared to CON and TR.
• PE and QG offer benefits for global motor symptoms (UPDRS-III) compared to CON.
• Findings guide exercise selection for PD, but mechanisms and BGT's TUG superiority require further research.