The effect of exercise interventions on executive function in individuals with Parkinson’s disease: A meta-analysis of main and moderator effects

IF 2.7 3区医学 Q1 BEHAVIORAL SCIENCES

Biological Psychology Pub Date : 2025-06-06 DOI:10.1016/j.biopsycho.2025.109061

Cheng-Liang Chang , Sz-Yan Wu , Daphne I. Ling , Chia-Liang Tsai

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引用次数: 0

Abstract

Objective

Given the uncertainty surrounding the most effective exercise prescription variables (frequency, intensity, type, duration) and the impact of Parkinson’s disease (PD) characteristics (illness duration, age, severity, baseline cognitive status, levodopa dosage) on different subdomains of executive function (EF) improvement, we conducted a systematic review and meta-analysis with moderator analysis to assess these effects.

Method

Six electronic databases (Embase, PubMed, MEDLINE, Academic Search Complete, CINAHL, AGELINE) were searched by two independent authors. Clinical trials published before April 2024 that reported the effect of chronic exercise on EF in individuals with PD were included.

Results

Of 608 identified studies, 18 studies met eligibility criteria. The overall effect size (ES) of exercise on EF was small but positive and significant (ES= 0.21, p < .001). Among EF subdomains, cognitive flexibility showed significant improvement. Regarding exercise prescription, larger ES were observed for high (≥2 per week) frequency, moderate to vigorous intensity, mind-body exercise, and 45–60 min for each session. Sample characteristics such as older age, high levodopa equivalent daily dosage (LEDD) (≥600 mg/day), and baseline cognitive impairment were found to attenuate the effect of exercise on EF.

Conclusion

Exercise is a promising non-pharmacological intervention for enhancing EF in PD, particularly improving cognitive flexibility. Mind-body exercises appear particularly effective. Recommended programs should be moderate to vigorous in intensity, lasting 45–60 min, and conducted at least twice weekly for 13–16 weeks. The benefits of exercise diminish with age and with LEDD exceeding 600 mg/day. Additionally, PD patients with cognitive impairments may experience reduced benefits. Early exercise engagement is recommended, while disease severity and duration have minimal impact.

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运动干预对帕金森病患者执行功能的影响：主效应和调节效应的荟萃分析

考虑到最有效的运动处方变量（频率、强度、类型、持续时间）和帕金森病（PD）特征（病程、年龄、严重程度、基线认知状态、左旋多巴剂量）对执行功能（EF）改善不同子域的影响的不确定性，我们进行了系统回顾和meta分析，并使用调节分析来评估这些影响。方法2名独立作者对Embase、PubMed、MEDLINE、Academic Search Complete、CINAHL、AGELINE 6个电子数据库进行检索。2024年4月之前发表的临床试验报告了慢性运动对PD患者EF的影响。结果在608项研究中，18项研究符合入选标准。运动对EF的总体效应量（ES）虽小，但正且显著（ES= 0.21, p <； .001）。认知灵活性在EF子域间有显著提高。关于运动处方，高频率（每周≥2次）、中高强度、身心运动和每次45-60 min时观察到较大的ES。研究发现，年龄较大、高左旋多巴当量日剂量（LEDD）（≥600 mg/天）和基线认知障碍等样本特征会减弱运动对EF的影响。结论运动是一种很有前景的非药物干预措施，可以提高帕金森病患者的EF，尤其是认知灵活性。身心锻炼似乎特别有效。推荐的锻炼计划应该是中等到剧烈的强度，持续45-60 分钟，每周至少进行两次，持续13-16周。运动的好处随着年龄的增长而减少，当LEDD超过600 毫克/天。此外，患有认知障碍的PD患者获益可能会减少。建议尽早进行运动，而疾病的严重程度和持续时间对运动的影响最小。

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来源期刊

Biological Psychology 医学-行为科学

CiteScore

4.20

自引率

11.50%

发文量

146

审稿时长

3 months

期刊介绍： Biological Psychology publishes original scientific papers on the biological aspects of psychological states and processes. Biological aspects include electrophysiology and biochemical assessments during psychological experiments as well as biologically induced changes in psychological function. Psychological investigations based on biological theories are also of interest. All aspects of psychological functioning, including psychopathology, are germane. The Journal concentrates on work with human subjects, but may consider work with animal subjects if conceptually related to issues in human biological psychology.