Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis

Abstract Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well...

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Autores principales:	Jia-Hung Chen, Tsai-Wei Huang, Chien-Tai Hong
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/1c8535d8cab14bd297808bd418a10c1a
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spelling	oai:doaj.org-article:1c8535d8cab14bd297808bd418a10c1a2021-11-28T12:23:19ZCholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis10.1038/s41531-021-00251-12373-8057https://doaj.org/article/1c8535d8cab14bd297808bd418a10c1a2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00251-1https://doaj.org/toc/2373-8057Abstract Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: −0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: −0.43, 95% CI = −0.79 to −0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.Jia-Hung ChenTsai-Wei HuangChien-Tai HongNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Jia-Hung Chen Tsai-Wei Huang Chien-Tai Hong Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
description	Abstract Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: −0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: −0.43, 95% CI = −0.79 to −0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.
format	article
author	Jia-Hung Chen Tsai-Wei Huang Chien-Tai Hong
author_facet	Jia-Hung Chen Tsai-Wei Huang Chien-Tai Hong
author_sort	Jia-Hung Chen
title	Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
title_short	Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
title_full	Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
title_fullStr	Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
title_full_unstemmed	Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis
title_sort	cholinesterase inhibitors for gait, balance, and fall in parkinson disease: a meta-analysis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1c8535d8cab14bd297808bd418a10c1a
work_keys_str_mv	AT jiahungchen cholinesteraseinhibitorsforgaitbalanceandfallinparkinsondiseaseametaanalysis AT tsaiweihuang cholinesteraseinhibitorsforgaitbalanceandfallinparkinsondiseaseametaanalysis AT chientaihong cholinesteraseinhibitorsforgaitbalanceandfallinparkinsondiseaseametaanalysis
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Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis

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