Critically appraised paper: Exercise interventions improve some walking-related outcomes in people with Parkinson’s disease [commentary]

Objective: To review the evidence ofwhether exercise improveswalkingrelated outcomes in people with Parkinson’s disease. Data sources: MEDLINE, CINAHL Plus, PubMed, and SPORTDiscus were searched up to June 2017. Study selection: Randomised controlled trials involving people with Parkinson’s disease, and in which exercise interventions were compared to non-exercise control interventions or another form of exercise. Outcome measures were: gait speed (comfortable and fast), stride/ step length, cadence, double-leg support time (percentageof thegait cycle duration), Timed Up and Go test, 6-minute walk test, Freezing of Gait questionnaire, and the Dynamic Gait Index. Data extraction: Two reviewers extracted data. Methodological quality was assessed using the PEDro Scale,with differences in ratings resolved throughdiscussion.Data synthesis: Of 669 trials initially identified, 40 were included in the metaanalysis,witha totalof1656participants ranging inHoehnandYahr stages I to IV. PEDro scores ranged from 3 to 8 points, indicating low to high methodological quality. The studies evaluated a vast array of exercise interventions, includingbalance training, physiotherapy, resistance training, treadmill and overground gait training, Tai Chi, yoga, boxing, cycling, and aquatic therapy.When compared to non-exercise control groups, exercise