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Improves strength (Parkinson’s evidence)

Evidence Summary
A variety of strength training activities can help improve muscle strength and functional mobility in Parkinson’s.

Evidence summary: A number of systematic reviews and meta-analysis has found that strength training exercises such as Pilates, activities using machines and exercise bands helps not just in improving strength but can have an impact on functional mobility, muscle strength, balance, motor symptoms and walking cadence [1 – 6]. The recommendation is to start at early stages of disease, and also associate activities on a cycle ergometer or treadmill with global muscle resistance training [6]. Review of 8 studies showed safe progressive activity in Pilates, calisthenics and other resistance training had positive impact on physical fitness, lower limb strength, functional mobility and cadence but recommended initial supervision with an instructor [1].

There is also evidence to show that upper and lower limb resistance training has more benefit in the early stages of Parkinson’s [4].

Quality of Evidence
B – This evidence is based on systematic reviews and meta-analysis but the studies done are based on small numbers.

Strength of Recommendation
1 – As well as improvements of strength, there are improvements in numerous other functional mobility measures.

Conclusion
Strength training should be included regularly in activities recommended for People with Parkinson’s particularly in the early stages of Parkinson’s.

References
[1] Suárez-Iglesias D et al. Benefits of Pilates in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2019 Aug 13;55(8):476.
[2] Chung CL et al. Effectiveness of resistance training on muscle strength and physical function in people with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil. 2016. PMID: 25691582 Review.
[3] Paolucci et al Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review.
Parkinsons Dis. 2020 May 26;2020:9748091.
[4] Cruickshank et al. A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson’s disease. Medicine. 2015, Jan.
[5] Lima et al. Progressive resistance exercise improves strength and physical performance in people with mild to moderate Parkinson’s disease: a systematic review. Journal of Physiotherapy, 2013, March 59(1): 7-13.
[6] Tambosco et al. Effort training in Parkinson’s disease: a systematic review. Annals of physical rehabilitation medicine 2014 Mar, 57(2): 79-104.

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