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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

Subgroup analysis forest plot of comparison: 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, using post-intervention values.Outcome: knee extension strength. CI = confidence interval; IV = inverse variance; SMD = standardized mean difference.
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pone.0132135.g005: Subgroup analysis forest plot of comparison: 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, using post-intervention values.Outcome: knee extension strength. CI = confidence interval; IV = inverse variance; SMD = standardized mean difference.

Mentions: Results of the subgroup analysis according to differences in study design are summarized in Fig 5. The largest knee extension strength levels were found in people who performed RT for 24 weeks compared to people who underwent a stretching intervention (MD 41.70 Nm [95% CI 29.33, 54.07]) [40]. Knee extension strength was also significantly higher in people who undertook RT combined with another form of exercise (e.g. aerobic, balance training) compared to people who did not engage in any intervention after 6 weeks [38], 10 weeks [43] or 6 months [36] of training (SMD 0.54 [95% CI 0.05, 1.02]). There was significant heterogeneity (P = 0.05; I2 = 75%) in the fourth subgroup analysis (RT with other form of exercise vs. control-with-intervention). Using a random effects model knee extension strength was not significantly higher in people who undertook RT concurrently with balance or stretching exercise for 10 weeks [39] or 3 months [42] than in people who engaged in balance [39] or treadmill training [42] (SMD 0.95 [95% CI -0.54, 2.43]; data not displayed).


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)

Subgroup analysis forest plot of comparison: 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, using post-intervention values.Outcome: knee extension strength. CI = confidence interval; IV = inverse variance; SMD = standardized mean difference.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4492705&req=5

pone.0132135.g005: Subgroup analysis forest plot of comparison: 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, using post-intervention values.Outcome: knee extension strength. CI = confidence interval; IV = inverse variance; SMD = standardized mean difference.
Mentions: Results of the subgroup analysis according to differences in study design are summarized in Fig 5. The largest knee extension strength levels were found in people who performed RT for 24 weeks compared to people who underwent a stretching intervention (MD 41.70 Nm [95% CI 29.33, 54.07]) [40]. Knee extension strength was also significantly higher in people who undertook RT combined with another form of exercise (e.g. aerobic, balance training) compared to people who did not engage in any intervention after 6 weeks [38], 10 weeks [43] or 6 months [36] of training (SMD 0.54 [95% CI 0.05, 1.02]). There was significant heterogeneity (P = 0.05; I2 = 75%) in the fourth subgroup analysis (RT with other form of exercise vs. control-with-intervention). Using a random effects model knee extension strength was not significantly higher in people who undertook RT concurrently with balance or stretching exercise for 10 weeks [39] or 3 months [42] than in people who engaged in balance [39] or treadmill training [42] (SMD 0.95 [95% CI -0.54, 2.43]; data not displayed).

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