OBJECTIVES: The effects of mind-body exercises on individuals with chronic illnesses have attracted increasing attention. However, little effort had been made to systematically review the effects of these mind-body exercises on individuals with Parkinson's disease (PD). This review aimed to appraise the current evidence of the effects of mind-body exercises on the physiological and psychological outcomes for the PD population.
DESIGN: Systematic review and meta-analysis of randomized controlled trials.
DATA SOURCES: Four English databases, namely, the EMBASE, Ovid Medline, Psych Info, and Cochrane Library, were searched on January 2016.
REVIEW METHODS: Studies involving participants with idiopathic PD were included if mind-body exercises were applied and compared with a non-exercise control to improve physiological and psychosocial well-being. The Effective Public Health Practice Project quality assessment tool was used for quality appraisal. RevMan 5.3 was employed to perform this meta-analysis. A subgroup analysis regarding the types and the dose of intervention was conducted to explore the sources of heterogeneity.
RESULTS: Ten studies met the inclusion criteria for quality appraisal. The overall methodological rating of these studies indicated that one study was strong; five studies were moderate; and four studies were weak. Nine articles comprising five Tai Chi, two yoga, and two dance studies were included in the meta-analysis. The results of this review showed that mind-body exercises had a large, significant beneficial effect in motor symptoms in terms of UPDRS III for people with mild to moderate PD [SMD=-0.91, 95% CI (-1.37, -0.45), p<0.05]. Significant subgroup differences were found among various types of mind-body exercises (p=0.001). Yoga demonstrated the largest and most significant beneficial effect in reducing UPDRS III scores [SMD=-2.35, 95% CI (-3.21, -1.50), p<0.01]. The pooled meta-analysis results showed that mind-body exercises had a large, significant effect in improving postural instability in terms of the Berg Balance Scale [SMD=1.48, 95% CI (0.91, 2.06), p<0.01] and Timed Up and Go test [SMD=-0.97, 95% CI (-1.46, -0.47), p<0.01] and moderate, significant effect in improving functional mobility in terms of the Six-minute Walk test [SMD=0.78, 95% CI (0.35, 1.21), p<0.05].
CONCLUSIONS: This review found that mind-body exercises demonstrated immediate moderate to large beneficial effects on motor symptoms, postural instability, and functional mobility among individuals with mild to moderate PD. However, the effects of mind-body exercises on psychosocial well-being had not been amply investigated, especially for yoga intervention. Future research should address the psychosocial effects of mind-body exercises on the PD population.
Copyright © 2016 Elsevier Ltd. All rights reserved.
KEYWORDS: Chronic illness; Exercise; Mind-body; Parkinson; Systematic review
PMID: 27912936 DOI: 10.1016/j.ctim.2016.09.016
