Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To give an update on randomized controlled trials (RCT) including non-pharmacological intervention approaches that examine effects on fatigue in people with Parkinson’s disease (PD).
Background: As fatigue is one of the most common and debilitating non-motor symptoms among PD patients and exerts a significant impact on quality of life, effective treatment options are highly needed.
Method: This systematic review was pre-registered in PROSPERO (CRD42021257853). We searched MEDLINE, EMBASE, PsycINFO, CENTRAL, and CINAHL for (cross-over) RCT on interventions for treating fatigue in PD until May 2021. Meta-analyses for random-effects models were calculated using standardized mean differences (SMD) with 95% confidence intervals (CI).
Results: 16 non-pharmacological intervention trials including physical exercise (n = 9), occupational therapy (n = 1), acupuncture (n = 2), bright light therapy (n = 2), sleep hygiene training combined with bright light therapy and cognitive-behavioural therapy (n = 1), and a mindfulness-based intervention approach (n = 1) were identified. Meta-analyses were calculated for physical exercise versus passive or placebo control groups, acupuncture versus placebo, and bright light therapy versus placebo. However, only physical exercise following different training approaches (e.g., endurance and resistance training, Nordic walking, and dancing) versus passive or placebo control groups showed a small significant effect in favour of physical exercise (SMD = -0.34, 95% CI -0.64 – -0.04, p = .03).
Conclusion: Our review indicates that physical exercise may be a promising strategy to treat fatigue in PD. Further research will have to examine the efficacy of this and further interventions. Here, effects on physical and mental fatigue should be differentiated since different underlying mechanisms of these symptoms may lead to different treatment responses. More effort is necessary to develop, evaluate and implement holistic fatigue management strategies for PD patients.
To cite this abstract in AMA style:
A. Folkerts, J. Nielsen, R. Gollan, A. Lansu, D. Solfronk, I. Monsef, N. Skoetz, K. Zeuner, E. Kalbe. Physical exercise as a promising option for treating fatigue in Parkinson’s disease? Results of a systematic review and meta-analysis of non-pharmacological interventions [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/physical-exercise-as-a-promising-option-for-treating-fatigue-in-parkinsons-disease-results-of-a-systematic-review-and-meta-analysis-of-non-pharmacological-interventions/. Accessed June 14, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/physical-exercise-as-a-promising-option-for-treating-fatigue-in-parkinsons-disease-results-of-a-systematic-review-and-meta-analysis-of-non-pharmacological-interventions/