Table 1.
General characteristics of these included articles concerning the effects of lower limb RT in individuals with PD.
| References | Year | Study design | Sex ratio (M/F) | Age (Mean ± SD) | N (E/C) | Hoehn-Yahr Stage + duration (n) | Frequency+intervention time | Follow-up period | Outcome measures and relevant parameter changes | Group Training | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RT | Control | ||||||||||
| Silva-Batista et al. (27), Brazil | 2020 | RCT | 21/11 | 65.6 ± 9.7 | 17/15 | 3~4; 8.8 ± 4.9 |
80~90 mi, 3/wk; 12 wk |
12 wk | 1.FOGQ(↓); 2.PDQ-39(↓). | Lower and upper limb PRT. *Half-squat; plantar flexion; knee lifting stand; lunge; reverse fly; dual-task squat. |
Traditional motor |
| Vieira De Moraes Filho et al. (17), UK | 2020 | Single blinded RCT | 30/10 | 64.6 ± 2.6 | 25/15 | 1~3; 6.3 ± 1.5 |
50~60mi, 2/wk; 9 wk |
9 wk | 1.TMWT(↑); 2.TUG(↓). | Lower limb and trunk RT. *Knee extension; hamstrings curl; leg press; seated row. |
No intervention |
| Kwok et al. (16), Hong Kong | 2019 | Single blinded RCT | 65/73 | 63.6 ± 8.7 | 67/71 | 1; NR |
60 mi, 2/wk; 8 wk |
0, 8, 20 wk | 1.TUG(↓); 2.PDQ8(↓). | Lower and upper limb SRTE. *Resistance training and stretching. |
Mindfulness yoga |
| de Lima et al. (10), Brazil | 2019 | Single blinded RCT | NR | 66.7 ± 5.3 | 17/16 | 1~3; NR |
30~40mi, 2/wk; 20 wk |
20 wk | 1.PDQ39(↓); 2.Gait velocity(↑); 3. TUG(↓). | Lower and upper limbs RT. * Bench press, unilateral rowing, standing calf raise, and abdominal reverse crunch. |
No intervention |
| Shen et al. (28), China | 2019 | RCT | 47/38 | 65 ± 4.8 | 40/45 | 1~4; 4.6 ± 1.9 |
NR; 18 mo |
0,3,12,18 mo | BBS(↑). | Lower and upper limb PRT. | No intervention |
| Tang et al. (23), China | 2019 | RCT | 43/19 | 68.7 ± 5 | 31/31 | 1~3; 4 ± 2.2 |
20 mi, 2/wk; 12 wk |
12 wk | 1.Muscle strength(↑); 2.BBS(↑). | Medium and low intensity lower limb PRT. *Elastic band leg lift; lunge with elastic band; side pull of elastic band; seated leg lifts. |
No intervention |
| Leal et al. (29), Brazil | 2019 | Single blinded RCT | 27/27 | 65.1 ± 2.2 | 27/27 | 1~3; NR |
20 mi, 2/wk; 6 mo |
6 mo | 1.TMT-B(↑); 2.6MWT(↑); 3.TUG(↓). | Low-volume lower and upper limb RT. *Bench press; deadlift; unilateral rowing; standing calf raise; abdominal reverse crunch. |
No intervention |
| Schlenstedt et al. (30), Germany | 2018 | Single blinded RCT | 15/5 | 79.5 ± 6.4 | 12/8 | 2.5~3; 10.1 ± 6.8 |
60 mi, 2/wk; 7wk |
8, 12 wk | 1.FAB(↓); 2.FOGQ(↓). | Moderate frequency lower limb RT. *Squats; knee extensions; toe/calf raises; hip abductions. |
Balance training |
| Ferreira et al. (9), Brazil | 2018 | Single blinded RCT | NR | 65.8 ± 8.1 | 18/17 | 1~3; 5.5 ± 3.5 |
30~40mi, 2/wk; 24 wk |
24 wk | PDQ39(↓). | Lower and upper limb RT. *Bench press; unilateral rowing; standing calf raise. |
No intervention |
| Silva-Batista et al. (7), Brazil | 2018 | RCT | 19/7 | 64.2 ± 8.5 | 13/13 | 2~3; 10.2 ± 5.1 |
60 mi, 2/wk; 12 wk |
12 wk | BESTest(↑) | Lower and upper limb PRT. *Half-squat; plantar flexion; leg-press. |
No intervention |
| Morris et al. (31), Australia | 2017 | Single blinded RCT | 80/53 | 71 ± 9 | 67/66 |
1~4; NR |
60 mi, 1/wk; 6 wk |
12 mo | PDQ-39(↑). | Lower limbs and trunk PRT. *Step-ups; heel raises; sit-to-stand movements; standing hip abduction exercises. |
No intervention |
| Santos S et al. (32), Brazil | 2017 | Single blinded RCT | 28/12 | 67.8 ± 7.1 | 19/21 | 1.5~3; 5.5 ± 4.8 |
60 mi, 2/wk; 8 wk |
8 wk | BESTest(↓). | Lower limbs and trunk RT. *Muscular strengthening; stretching training. |
Balance training |
| Santos L et al. (26), Spain | 2017 | RCT | 15/13 | 73.6 ± 7.8 | 13/15 | 1~2; 10.6 ± 4 |
60~70mi, 2/wk; 8 wk |
0, 8, 12 wk | 1.TMWT(↑); 2.FOGQ(→); 3.PDQ39(↓); 4.Stride length(↓). | Lower and upper limb PRT. *Knee extension; knee flexion. |
Activity routine |
| Ortiz-Rubio et al. (33), Spain | 2017 | Single blinded RCT | 33/13 | 74.8 ± 6.1 | 23/23 | 2~3; 4.1 ± 2 |
60 mi, 2/wk; 8 wk |
8 wk | Mini-BES Test(↑). | Lower limb PRT. *Strengthening all major muscle power seated with elastic bands. |
Seated stretching |
| Rafferty et al. (34), USA | 2017 | Single blinded RCT | 28/20 | 58.8 ± 5.1 | 24/24 | 2.5~3; 6.5 ± 4.7 |
60~90mi, 2/wk; 24 mo |
6, 12, 18, 24 mo | Stride length(↓). | Trunk, lower and upper limb PRT. *Double leg press; hip extension; rotary calf; seated quadriceps extension. |
MFCE |
| Kanegusuku et al. (35), Brazil | 2017 | RCT | 22/5 | 65.2 ± 8.1 | 15/12 | 2~3; 8.7 ± 4.6 |
30~60mi, 2/wk; 12 wk |
12 wk | 1RM(↑). | Lower and upper limb PRT. *Horizontal leg press, squat, rotary calf, 17 lateral pull down |
No intervention |
| Silva-Batista et al. (36), Brazil | 2016 | RCT | 19/7 | 64.2 ± 8.5 | 13/13 | 2~3; 10.2 ± 5 |
60 mi, 2/wk; 12wk | 12 wk | 1.TUG(↑); 2.PDQ39(↓); 3.1RM(↑). | Lower and upper limb PRT. *Leg-press; latissimus dorsi pull-down; ankle plantar flexion; half-squat. |
No intervention |
| Ni et al. (37), USA | 2016 | RCT | 13/11 | 73 ± 7.4 | 14/10 | 1~3; 6.3 ± 5.1 |
45~60mi, 2/wk; 12 wk |
12 wk | 1.Muscle strength(↑); 2.PDQ39(↓). | Lower and upper PWT. *Leg press; leg curl; hip abduction; seated calf. |
YOGA |
| Li et al. (13), USA | 2015 | RCT | 77/53 | 69 ± 8.5 | 65/65 | 1~4; 7 ± 7.3 |
60 mi, 2/wk; 24 wk |
24 wk | PDQ8(→). | Lower limb PRT. *Forward and side steps; squats; forward and side lunges; heel and toe raises. |
Stretching |
| Ni et al. (38), USA | 2015 | RCT | 20/7 | 71.4 ± 6.4 | 14/13 | 1~3; 6.7 ± 5.3 |
45~60mi, 2/wk; 12 wk |
12 wk | 1.BBS(↑); 2.TUG(↑); 3.Mwalk(↓); 4.1RM(↑↓→). | Lower and upper limb PWT. *Leg press; leg curl; hip abduction; seated calf. |
YOGA |
| Dibble et al. (39), USA | 2015 | Single blinded RCT | 25/16 | 68.4 ± 12.3 | 20/21 | 2~4; 6.8 ± 4.5 |
60 mi, 2/wk; 12 wk |
12 wk | 1.Leg strength(↓); 2.6MWT(↓). | Lower limb RT. *Training of bilateral lower extremity extensor musculature. |
Regular exercises |
| Prodoehl et al. (40), USA | 2015 | Single blinded RCT | 28/20 | 58.8 ± 5.1 | 24/24 | NR; 6.5 ± 4.4 |
60~90mi, 2/wk; 24 mo |
6, 24 mo | 1.TUG(↑); 2.BBS(↓); 3.6MWT(↓). | Upper and lower limb PRT. *Double leg press; hip extension; rotary calf; seated quadriceps extension. |
MFCE |
| Schlenstedt et al. (41), Germany | 2015 | Single blinded RCT | 21/11 | 75.7 ± 6.3 | 17/15 | 2.5~3; 9.7 ± 6.9 |
60 mi, 2/wk; 7wk |
8, 12 wk | 1.FAB(↓); 2.TUG(↑); 3.Stride length(↓) and gait velocity(↓); 4.Leg strength(↓); 5.PDQ39(↓). | Lower limb RT. *Squats; knee extensions; toe/calf raises; hip abductions. |
Balance training |
| Paul et al. (42), Australia | 2014 | Single blinded RCT | 25/15 | 66.3 ± 6.7 | 20/20 | 1~3; 7.8 ± 5.5 |
45 mi, 2/wk; 12 wk |
12 wk | 1.Muscle strength(↑); 2.TUG(↓); 3.FOGQ(↓); 4.Gait velocity(↑); 5.Balance(↑). | Lower limb RT. *Leg extensors; knee flexors; hip flexors; hip abductors. |
Sham exercise |
| Shulman et al. (43), USA | 2013 | Single blinded RCT | 34/10 | 65.6 ± 11.3 | 22/22 | 1~3; 6.3 ± 3.7 |
30 mi, 3/wk; 3 mo |
3 mo | 1.6MWT(↓); 2.1RM(↑). | Lower limb RT. *Hip abduction; stretches of calves, hamstrings, quadriceps, and ankles. |
Treadmill exercise |
| Corcos et al. (44), USA | 2013 | Single blinded RCT | 28/20 | 58.8 ± 5.1 | 24/24 | 2.5~3; 6.5 ± 4.4 |
60~90mi, 2/wk; 24 mo |
6,12,18,24 mo | PDQ-39(↓). | Lower and upper limb PRT. *Double leg press; hip extension; rotary calf (ankle plantar flexion; seated quadriceps extension. |
MFCE |
| Li et al. (45), USA | 2012 | RCT | 77/53 | 69 ± 8.5 | 65/65 | 1~4; 7 ± 7.3 |
60 mi, 2/wk; 24 wk |
24 wk | 1.Stride length(↑); 2.Gait velocity(↑); 3.TUG(↓). | Lower limb PRT. *Forward and side steps; squats; forward and side lunges; heel and toe raises. |
Stretching |
| Hass et al. (46), USA | 2012 | RCT | 14/4 | 65.5 ± 7.5 | 9/9 | 1~3; 8.8 ± 7.4 |
60 mi, 2/wk; 10 wk |
10 wk | 1.Stride velocity(↑); 2.Stride length(↓); 3.1 RM(↑). | Lower limb PRT. *Seated leg press; knee extension;knee flexion; seated calf raise; multi-directional seated ankle theraband. |
No intervention |
| Allen et al. (47), Australia | 2010 | Single blinded RCT | 26/22 | 67 ± 8.6 | 24/24 | NR; 8 ± 5.6 |
40~60mi, 3/wk; 6 mo |
6 mo | 1.Muscle Strength(↑); 2.BBS(↓); 3.FOGQ(↓); 4.Gait velocity(↑); 5.PDQ39(↓). | Lower limb PRT. *Stepping and standing; walking; sit-to-stand; heel raises; lateral and forward step-up, half-squats sliding; standing on one leg. |
No intervention |
| Schilling et al. (48), USA | 2010 | RCT | 11/7 | 59.3 ± 8 | 9/9 | 1~2.5; NR |
40 mi, 2/wk; 8 wk |
8 wk | [n] RM(↑); 2.TUG(↓); 3.6MWT(↑); 4.ABC(↑). |
Moderate volume, high-load, lower limb RT. *Leg press; leg curl; calf press. |
No intervention |
| Hirsch et al. (49), USA | 2003 | RCT | NR | 73.7 ± 3.3 | 6/9 | 1~3; 7.2 ± 7.9 |
15 mi, 3/wk; 10 wk |
10,14 wk | 1.EquiTest(↑); 2.Muscle Strength(↑). | High-intensity lower limb PRT. *Ankle plantarflexors; knee extensors; flexors. |
Balance training |
↑, increase; ↓, decrease; → , no changes; RT, Resistance training; PRT, Progressive resistance training; BT, Balance training; PWT, Power training; SRTE, Stretching and resistance training exercises; NR, Not reported; mi, minute; wk, week; mo, month; MFCE, Modified fitness counts exercise; TUG, Timed-up-and-go-test; FOG-Q, Freezing of Gait Questionnaire; QoL, Quality of life; PDQ-39, Parkinson's Disease Questionnaire; 1-RM, One repetition maximum; MWT, Meter walking tests; BBS, Berg Balance Scale; FAB, Fullerton Advanced Balance; BESTest, Balance Evaluation systems test; ABC, Activities-specific Balance Confidence.