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Exercise interventions improve motor function and freezing of gait scores in Parkinson's diseaseExercise Interventions May Improve Movement and Balance in Parkinson's

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Key Takeaway
Consider exercise interventions to improve motor function and freezing of gait in patients with Parkinson's disease.

This meta-analysis evaluated the impact of exercise interventions on motor symptoms and balance in 714 patients with Parkinson's disease. The analysis synthesized data across multiple scales, including the Freezing of Gait Questionnaire (FOGQ), Unified Parkinson's Disease Rating Scale Part III (UPDRS-III), Berg Balance Scale (BBS), and Mini-Balance Evaluation Systems Test (Mini-BESTest).

Key findings indicated that exercise interventions were associated with lower FOGQ scores (SMD = -0.62; 95% CI -1.06 to -0.18) and lower UPDRS-III scores (SMD = -0.80; 95% CI -1.02 to -0.59). Additionally, higher scores were observed on the Berg Balance Scale (SMD = 0.85; 95% CI 0.27 to 1.42). However, the effect on the Mini-BESTest was not statistically significant (SMD = 0.23; 95% CI -0.24 to 0.70).

The authors noted several limitations, including methodological issues within the included trials and low certainty of evidence for FOGQ, BBS, and Mini-BESTest. The evidence for Mini-BESTest outcomes remains inconclusive. Clinically, these findings suggest that exercise may improve freezing-of-gait symptoms and overall motor function in patients with Parkinson's disease, though the strength of evidence for specific balance measures is limited.

How this fits prior evidence

This meta-analysis extends the current evidence base for Parkinson's disease management by specifically evaluating exercise interventions for motor symptoms. It complements the finding that resistance training shows the largest effect for global cognition in Alzheimer's and Parkinson's disease by providing evidence for physical improvements in gait and motor scores. While the current study shows significant improvements in UPDRS-III and FOGQ, it highlights the limitations of current evidence for specific balance metrics like Mini-BESTest.

A review of data from 714 patients with Parkinson's disease looked at how different exercise programs affect movement and balance. The study focused on several key areas, including the ability to walk without stopping suddenly and overall motor function.

Researchers found that exercise was linked to lower scores on scales measuring freezing of gait and general motor problems. Patients also showed higher scores on balance scales, suggesting better stability. However, the evidence for some specific balance tests was not statistically significant and remains inconclusive.

Because the quality of the original trials varied, the evidence for some improvements is considered low or uncertain. While exercise shows promise for managing symptoms and improving mobility, the results are not definitive for every type of balance test. Patients should talk to their doctors to determine which specific exercise routines are safest and most effective for their individual needs.

What this means for you:
Exercise may improve balance and movement for those with Parkinson's, but results vary across different tests.

Common questions

Can exercise help with freezing of gait in Parkinson's?

The study found that exercise interventions were linked to lower scores on the Freezing of Gait Questionnaire. This suggests that exercise may help manage symptoms where a person's feet feel stuck to the floor. However, the researchers noted that the certainty of evidence for this specific outcome is low.

Does exercise improve balance for Parkinson's patients?

Patients who participated in exercise programs showed higher scores on the Berg Balance Scale. This indicates an improvement in balance. However, results for the Mini-Balance Evaluation Systems Test were not statistically significant, meaning the evidence for that specific test is still unclear.

How much did exercise improve motor function?

The study reported lower scores on the Unified Parkinson's Disease Rating Scale Part III, which measures motor function. This indicates that exercise may help with overall movement. The evidence for this specific finding was rated as moderate by the researchers.

Study Details

Study typeMeta analysis
Sample sizen = 714
EvidenceLevel 1
PublishedJan 2026
View Original Abstract ↓
OBJECTIVE: Evidence regarding the effects of exercise interventions on gait-related symptoms, motor function, and balance in patients with Parkinson's disease (PD) remains uncertain across outcome measures and intervention characteristics. This study aimed to evaluate the effects of exercise interventions on the Freezing of Gait Questionnaire (FOGQ), Unified Parkinson's Disease Rating Scale Part III (UPDRS-III), Berg Balance Scale (BBS), and Mini-Balance Evaluation Systems Test (Mini-BESTest), and to explore potential sources of heterogeneity. METHODS: Standardized mean differences (SMDs; Hedges' g) with 95% confidence intervals (CIs) were pooled using random-effects restricted maximum likelihood models. Exploratory subgroup analyses examined age, disease duration, intervention duration, training frequency, single-session duration, and exercise modality as potential sources of heterogeneity. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. This review was registered in PROSPERO (CRD420261281718). RESULTS: The meta-analysis included 20 randomized controlled trials published between 2009 and 2024, involving 714 patients with PD, including 372 participants in the exercise intervention groups and 342 in the control groups. Sixteen trials were judged as having some concerns and four as having a high overall risk of bias; none was rated as low risk. Compared with control conditions, exercise interventions were associated with lower FOGQ scores (SMD = -0.62, 95% CI -1.06 to -0.18) and UPDRS-III scores (SMD = -0.80, 95% CI -1.02 to -0.59), and higher BBS scores (SMD = 0.85, 95% CI 0.27 to 1.42). The pooled effect for Mini-BESTest was not statistically significant (SMD = 0.23, 95% CI -0.24 to 0.70). Exploratory subgroup analyses did not establish differential effects according to exercise modality, dose parameters, age, or disease duration. The certainty of evidence was moderate for UPDRS-III and low for FOGQ, BBS, and Mini-BESTest. CONCLUSION: Exercise interventions may improve freezing-of-gait symptoms, overall motor function, and some aspects of balance performance in patients with PD, although evidence for Mini-BESTest outcomes remains inconclusive. Given the limited certainty of evidence and methodological limitations of the included trials, these findings warrant cautious interpretation.
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