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英国埃克塞特大学留学生医学论文定制Review
The Effectiveness of Exercise Interventions for People with Parkinson’s Disease: A Systematic Review and Meta-Analysis
Victoria A. Goodwin, MSc,1* Suzanne H. Richards, PhD,1 Rod S. Taylor, PhD,1
Adrian H. Taylor, PhD,2 and John L. Campbell, MD1
1Primary Care Research Group, Peninsula Medical School, Exeter, United Kingdom
2School of Sport and Health Sciences, University of Exeter, United Kingdom
Abstract: Parkinson’s disease (PD) is a neurodegenerativedisorder affecting the physical, psychological, social, and functionalstatus of individuals. Exercise programs may be aneffective strategy to delay or reverse functional decline forpeople with PD and a large body of empirical evidence hasemerged in recent years. The objective is to systematicallyreview randomized controlled trials (RCTs) reporting on theeffectiveness of exercise interventions on outcomes (physical,psychological or social functioning, or quality of life) forpeople with PD. RCTs meeting the inclusion criteria wereidentified by systematic searching of electronic databases. Keydata were extracted by two independent researchers. A mixedmethods approach was undertaken using narrative, vote counting,and random effects meta-analysis methods. Fourteen RCTswere included and the methodological quality of most studieswas moderate. Evidence supported exercise as being beneficialwith regards to physical functioning, health-related quality oflife, strength, balance and gait speed for people with PD. Therewas insufficient evidence support or refute the value of exercisein reducing falls or depression. This review found evidence ofthe potential benefits of exercise for people with PD, althoughfurther good quality research is needed. Questions remainaround the optimal content of exercise interventions (dosing,component exercises) at different stages of the disease. © 2008Movement Disorder Society

Key words: Parkinson’s disease; exercise; systematic review; meta-analysis.
Exercise is a planned, structured physical activity
which aims to improve one or more aspects of physicalfitness.1 Current models of rehabilitation often use compensatory
strategies as the basis of therapeutic management.However, there is a growing body of evidence
regarding the benefits of exercise in terms of neuroplasticityand the ability of the brain to self repair.2 Animal
models have found that exercise has protective benefitsagainst the onset of symptoms in Parkinson’s disease
(PD).3 This appears to be due to the release of neurotrophic
factors, and greater cerebral oxygenation, whichtogether promote new cell growth and cell survival.4,5 InPD, it has been found that exercise stimulates dopaminesynthesis in remaining dopaminergic cells and thus reducing
symptoms.6 Fox et al.5 suggest there are five keyprinciples of exercise that enhance neuroplasticity inrelation to PD, these being: (a) intensive activity maximizessynaptic plasticity; (b) complex activities promote
greater structural adaptation; (c) activities that are rewardingincrease dopamine levels and therefore promote
learning/relearning; (d) dopaminergic neurones arehighly responsive to exercise and inactivity (“use it orlose it”); (e) where exercise is introduced at an earlystage of the disease, progression can be slowed.
It has been well documented that physical activitylevels decline with advancing age and these reductionscontribute to functional decline.7 People with PD havebeen shown本论文由英语论文网提供整理，提供论文代写，英语论文代写，代写论文，代写英语论文，代写留学生论文，代写英文论文，留学生论文代写相关核心关键词搜索。