A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease

Abstract Freezing of gait (FOG) in Parkinson’s disease (PD) causes severe patient burden despite pharmacological management. Exercise and training are therefore advocated as important adjunct therapies. In this meta-analysis, we assess the existing evidence for such interventions to reduce FOG, and...

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Autores principales:	Moran Gilat, Pieter Ginis, Demi Zoetewei, Joni De Vleeschhauwer, Femke Hulzinga, Nicholas D’Cruz, Alice Nieuwboer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/9f13bf20809b4b2b89c7fc8213875ae3
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spelling	oai:doaj.org-article:9f13bf20809b4b2b89c7fc8213875ae32021-12-02T14:54:27ZA systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease10.1038/s41531-021-00224-42373-8057https://doaj.org/article/9f13bf20809b4b2b89c7fc8213875ae32021-09-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00224-4https://doaj.org/toc/2373-8057Abstract Freezing of gait (FOG) in Parkinson’s disease (PD) causes severe patient burden despite pharmacological management. Exercise and training are therefore advocated as important adjunct therapies. In this meta-analysis, we assess the existing evidence for such interventions to reduce FOG, and further examine which type of training helps the restoration of gait function in particular. The primary meta-analysis across 41 studies and 1838 patients revealed a favorable moderate effect size (ES = −0.37) of various training modalities for reducing subjective FOG-severity (p < 0.00001), though several interventions were not directly aimed at FOG and some included non-freezers. However, exercise and training also proved beneficial in a secondary analysis on freezers only (ES = −0.32, p = 0.007). We further revealed that dedicated training aimed at reducing FOG episodes (ES = −0.24) or ameliorating the underlying correlates of FOG (ES = −0.40) was moderately effective (p < 0.01), while generic exercises were not (ES = −0.14, p = 0.12). Relevantly, no retention effects were seen after cessation of training (ES = −0.08, p = 0.36). This review thereby supports the implementation of targeted training as a treatment for FOG with the need for long-term engagement.Moran GilatPieter GinisDemi ZoeteweiJoni De VleeschhauwerFemke HulzingaNicholas D’CruzAlice NieuwboerNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-18 (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 Moran Gilat Pieter Ginis Demi Zoetewei Joni De Vleeschhauwer Femke Hulzinga Nicholas D’Cruz Alice Nieuwboer A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
description	Abstract Freezing of gait (FOG) in Parkinson’s disease (PD) causes severe patient burden despite pharmacological management. Exercise and training are therefore advocated as important adjunct therapies. In this meta-analysis, we assess the existing evidence for such interventions to reduce FOG, and further examine which type of training helps the restoration of gait function in particular. The primary meta-analysis across 41 studies and 1838 patients revealed a favorable moderate effect size (ES = −0.37) of various training modalities for reducing subjective FOG-severity (p < 0.00001), though several interventions were not directly aimed at FOG and some included non-freezers. However, exercise and training also proved beneficial in a secondary analysis on freezers only (ES = −0.32, p = 0.007). We further revealed that dedicated training aimed at reducing FOG episodes (ES = −0.24) or ameliorating the underlying correlates of FOG (ES = −0.40) was moderately effective (p < 0.01), while generic exercises were not (ES = −0.14, p = 0.12). Relevantly, no retention effects were seen after cessation of training (ES = −0.08, p = 0.36). This review thereby supports the implementation of targeted training as a treatment for FOG with the need for long-term engagement.
format	article
author	Moran Gilat Pieter Ginis Demi Zoetewei Joni De Vleeschhauwer Femke Hulzinga Nicholas D’Cruz Alice Nieuwboer
author_facet	Moran Gilat Pieter Ginis Demi Zoetewei Joni De Vleeschhauwer Femke Hulzinga Nicholas D’Cruz Alice Nieuwboer
author_sort	Moran Gilat
title	A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
title_short	A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
title_full	A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
title_fullStr	A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
title_full_unstemmed	A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease
title_sort	systematic review on exercise and training-based interventions for freezing of gait in parkinson’s disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/9f13bf20809b4b2b89c7fc8213875ae3
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A systematic review on exercise and training-based interventions for freezing of gait in Parkinson’s disease

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