Objective: To perform a systematic review assessing the effects of exercise on pain in people with Parkinson’s disease (PD) (PROSPERO registration CRD42019129154).

Background: Chronic pain affects a large proportion of people with PD, contributing to self-reports of discomfort and disability. Currently, pain management is guided by expert opinion which includes exercise as a recommended treatment.

Method: A literature search was performed on six electronic databases: MEDLINE, AMED, CENTRAL, CINAHL, EMBASE and PEDro from their inception. The inclusion criteria were: randomised or quasi-randomised controlled trials, participants with idiopathic PD; an experimental intervention where exercise was the main focus; and a measure of pain was reported. Methodological quality of original full-text articles was assessed using the PEDro scale. The primary outcome was pain. Adverse effects (e.g. injuries or pain exacerbation) and adherence to the exercise program were secondary outcomes. A preliminary random-effects meta-analysis that compared exercise with no exercise intervention (control) was conducted for the Parkinson’s Disease Questionnaire 39 (PDQ-39) bodily discomfort subscore.

Results: Twenty-one trials (1,217 participants) were eligible for the review. Four included trials had pain as the primary outcome. The exercise modalities trialled included Tai Chi, Qigong, dance, yoga, exergaming, multidisciplinary rehabilitation, aerobic, strength, aquatic agility exercise. The average PEDro score was 6/10, indicating good quality (Range: 4 – 8). Preliminary data from the random effects meta-analysis of PDQ-39 bodily discomfort subscore (10 trials, 713 participants) showed no statistically significant difference between the exercise and control group (Hedges’ g = -0.124, 95% CI -0.371 to 0.123, p = 0.327). There was a moderate amount of statistical heterogeneity (I² = 46.5, p = 0.024). Eleven trials reported no adverse events and four trials reported minor injury or exacerbations of pain. Ten trials reported adherence with an average of 91%.

Conclusion: Exercise is important for people with PD as it has positive effects on mobility and falls. Further research of interventions designed to reduce pain are needed. The effect of exercise on pain is unclear therefore exercise for people with PD and pain should be carefully prescribed and monitored.

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effect-of-exercise-on-pain-in-parkinsons-disease-a-systematic-review/