Effect of High-intensity Exercise in Parkinson’s Disease: A Systematic Review and Meta-analysis of Clinical Trials
Mohamed A. Abu Elainein1, Eman W. Badr2, Gamal M. Abdel meguid3, Mohamed Khalifa2, Aliaa Zidan4, Amira M. Gaber2, Mohamed Whdan1, Eman Zahran Mohamed2, Mostafa Meshref5
1Faculty of Medicine, Ain Shams University, 2Faculty of Medicine, Tanta University, 3Faculty of Medicine, Alexandria University, 4Faculty of Nursing, Tanta University, 5Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo
Objective:

To assess the effect of different exercise intensities in individuals with Parkinson’s disease.

Background:
Parkinson's disease affects the motor functions and the quality of life. While exercise shows a solution for improving the motor symptoms, optimal intensity still unclear. This meta-analysis compared high-intensity exercise with control and low-to-moderate intensity exercise to evaluate its effects on motor, aerobic, functional, and quality-of-life outcomes in individuals with Parkinson's disease.
Design/Methods:

Following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, we conducted a systematic literature search across 4 databases (PubMed, Web of Science, Scopus and Scholar) from inception till May 2025, the Cochrane risk of bias 2 tool was used for assessment of the quality of the included studies. Statistical analysis was performed using RevMan web software, random effect model has been utilized. Dichotomous outcomes were subjected to risk ratio analysis (RR), while continuous outcomes were pooled using mean difference (MD), all were reported with 95% confidence interval (CI).

Results:

Fourteen studies met inclusion criteria, of which 11 were included in the quantitative synthesis. High-intensity exercise significantly demonstrated improvement in motor function (UPDRS III MD –3.38; 95% CI –5.88 to –0.88; P = 0.008; I² = 2%), aerobic capacity (VO₂ max MD 2.27 mL·kg⁻¹·min⁻¹; 95% CI 1.24 to 3.29; P < 0.0001; I² = 49%), and quality of life (PDQ-39 MD –0.61; 95% CI –0.95 to –0.28; P = 0.0004; I² = 0%). No significant differences were noticed for activities of daily living (UPDRS II), overall disease severity (UPDRS total), or 6-minute walk distance. In direct comparison, high-intensity exercise demonstrated a non-significant increase in VO₂ max compared to low-to-moderate intensity.

Conclusions:

High-intensity exercise significantly improves motor function, aerobic capacity, and quality of life in Parkinson’s disease, supporting its integration into rehabilitation programs while underscoring the need for larger trials to evaluate nonmotor and functional outcomes.

10.1212/WNL.0000000000215737
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.