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Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.

Roeder L, Costello JT, Smith SS, Stewart IB, Kerr GK - PLoS ONE (2015)

Bottom Line: Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention.RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention.Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.

ABSTRACT

Objective: The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson's disease (PD).

Methods: Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design.

Results: Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention.

Discussion: Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.

No MeSH data available.


Related in: MedlinePlus

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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pone.0132135.g002: Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Mentions: There was a moderate to high risk of bias across all studies (Figs 2 and 3). Due to the nature of the intervention none of the studies utilized blinding of participants or personnel administering the exercises. Blinding of outcome assessors was reported in three studies [36,40,42]. There was a high risk of attrition bias across all studies; only one study [40] provided appropriate information relating to dropouts, exclusions, missing data and approach to analysis (intention-to-treat). Likewise, only one study [38] made any reference to a published protocol. Despite all studies stating that some form of randomization was employed, only four studies [35,36,40,42] provided adequate details on sequence generation and only one study [40] adequately reported allocation concealment.


Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.

Roeder L, Costello JT, Smith SS, Stewart IB, Kerr GK - PLoS ONE (2015)

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492705&req=5

pone.0132135.g002: Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Mentions: There was a moderate to high risk of bias across all studies (Figs 2 and 3). Due to the nature of the intervention none of the studies utilized blinding of participants or personnel administering the exercises. Blinding of outcome assessors was reported in three studies [36,40,42]. There was a high risk of attrition bias across all studies; only one study [40] provided appropriate information relating to dropouts, exclusions, missing data and approach to analysis (intention-to-treat). Likewise, only one study [38] made any reference to a published protocol. Despite all studies stating that some form of randomization was employed, only four studies [35,36,40,42] provided adequate details on sequence generation and only one study [40] adequately reported allocation concealment.

Bottom Line: Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention.RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention.Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.

ABSTRACT

Objective: The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson's disease (PD).

Methods: Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design.

Results: Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention.

Discussion: Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.

No MeSH data available.


Related in: MedlinePlus