Self-directed physical activity interventions for motor symptoms and quality of life in early and mid-stage Parkinson's disease: A systematic review and meta-analysis

Self-directed physical activity (SDPA) has been found in previous research to alleviate some of the symptoms of early and mid-stage Parkinson's disease (PD) patients. So, this study aimed to determine the impact of SDPA on these patients in the areas of motor symptoms, and quality of life (QoL). PubMed, Embase, the Cochrane Library, the Web of Science, Scopus, and ProQuest were all searched. The risk-of-bias tool of Cochrane for randomized trials, Version 2 (RoB 2), was also used to assess the credibility of studies in terms of their procedures. 15 eligible studies were analyzed. SDPA improved motor function and mobility, including timed up and go (TUG) test [standardized mean difference (SMD), −0.55 (95% CI, −0.91 – −0.18), p = 0.003], 6-minute walking (6MW) test [1.11 (0.75 − 1.47), p < 0.00001], stride length [0.45 (0.18 – 0.72), p = 0.001], gait velocity [0.42 (0.04 – 0.81 p = 0.03], Unified Parkinson's Disease Rating Scale Part-III (UPDRS-III) [−0.76 (−1.18 – −0.33), p = 0.0005] and enhanced Berg Balance Scale (BBS) [0.88 (0.50 – 1.27), p < 0.00001]). Despite engaging in SDPA, there was no significant improvement observed in freezing of gait (FOG) [0.23 (−0.11 – 0.56), p = 0.18] as well as the Parkinson's Disease Questionnaire-39 (PDQ-39) [0.04 (−0.55 – 0.62), p = 0.90]). The motor symptoms of those with early to mid-stage PD improved with SDPA, however the research found no enhancement in FOG or QoL.