Effectiveness of Exergaming-based Interventions for Mobility Performance in Older Adults with Parkinson’s Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Preprint)

Background: Although physical exercises can help older adults with Parkinson’s disease to retain their mobility function, older adults are less motivated to attend repeated and intensive physical training. Exergaming-based interventions have the potential to provide a more engaged and enjoyable therapy. However, few meta-analysis studies discussed the effectiveness of exergaming-based interventions on the mobility performance of older adults with Parkinson’s disease. Objective: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of exergaming-based interventions on mobility performance in older adults with Parkinson’s disease. Methods: Seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE, and PubMed) were searched to identify the RCTs which examined the effectiveness of exergaming on the mobility performance of older adults with Parkinson’s disease up to September 2021. Using meta-analysis, we assessed mobility performance between intervention groups and control groups by comparing basic mobility function with the Timed Up and Go (TUG), walking capability with 6-Minute Walk Test (6MWT), postural balance function with the Berg Balance Scale (BBS), and gait ability with gait velocity, stride length, and the Functional Gait Assessment (FGA). Results: After scanning 1110 articles, we identified and meta-analyzed 16 trials, including a total of 508 older adults with Parkinson’s disease. The results revealed statistical differences between intervention groups and control groups in the TUG (MD = -0.87; 95% CI = -1.60 to -0.15; P = .018), 6MWT (MD = 39.56; 95% CI = 1.21 to 77.91; P = 0.043), BBS (MD = 2.28; 95% CI = 1.42 to 3.14; P < .001), and FGA (MD = 1.40; 95% CI = -0.03 to 2.82; P = .054). The detectable clinically difference of the outcomes were discussed and the implications were provided. Conclusions: Exergaming is superior to traditional training in improving PD older adults’ basic mobility skills, walking capability, and postural balance function, while it has an equal effect with traditional physical training in enhancing PD older adults’ gait ability.