Objective: To examine the short- and long-term effects of exercise intervention on enhancing balance, and gait performance, and balance confidence in Parkinson’s disease (PD) population, and explore whether the intervention characteristics based on PD-specific impaired balance domains would influence balance outcomes.

Background: Previous meta-analyses indicated balance and gait training could enhance short- and long- term balance and single-task gait performance in people with PD. The effects on dual-task walking and balance confidence level were under investigated. Highly challenging balance activities may produce better results in balance outcomes. However, it is unknown whether training that comprised more balance control domains would result greater training effects.

Methods: Twenty three randomized controlled trials were included in meta-analyses to examine the effects of exercise intervention on balance, balance confidence and gait performance against no or active control interventions. Meta-regressions were conducted to explore if the number and the characteristics of the combined balance domains would be associated with treatment effects.

Results: Significant effects of exercise intervention were shown in enhancing balance performance (Hedges g = 0.425 over the short-term in 27 trials and 0.432 over the long-term in 14 trials), single- and dual-task gait performance (Hedges g = 0.280 over the short-term in 22 trials and 0.396 over the long-term in 10 trials), and balance confidence level (Hedges g = 0.378 over the short-term in 9 trials and 0.382 over the long-term in 5 trials). The longest follow-up duration was 52 weeks for balance and gait outcomes, and 10 weeks for balance confidence level. The study protocols targeted 2 to 6 PD-specific balance domains. Greater short-term benefits in balance performance were found in interventions that addressed more balance domains in addition to anticipatory postural adjustments, biomechanical constraints and/or dynamic control of gait.

Conclusions: The findings of our study support the use of exercise intervention to improve balance and gait performance, and balance confidence in people with PD over short- and long-terms. Addressing more balance domains could lead to a greater improvement in short-term balance ability.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-exercise-intervention-on-balance-and-gait-performance-and-balance-confidence-in-people-with-parkinsons-disease-a-meta-analysis/