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Research Article
October 11, 2022

Effects of Exercise on Depressive Symptoms in Patients With Parkinson Disease
A Meta-analysis

January 24, 2023 issue
100 (4) e377-e387

Abstract

Background and Objective

The purpose of this study was to provide clear evidence in support of the use of exercise to improve depressive symptoms in patients with Parkinson disease (PD) and to investigate whether this effect differs by exercise type and intensity.

Methods

Three independent reviewers searched for randomized controlled trials (RCTs) that applied exercise interventions with depressive symptoms as an outcome measure for patients with PD on PubMed and Web of Science up to February 28, 2022. Random-effects meta-analyses were performed, in which standardized mean differences (SMDs) between the effects of exercise and control interventions on depressive symptoms with 95% CIs were calculated.

Results

A total of 19 RCTs including 1,302 patients with PD were eligible for meta-analysis, and we obtained 23 comparisons from the included studies for data synthesis. Physical exercise interventions showed significant effects on the reduction in depressive symptoms in patients with PD (SMD = 0.829; 95% CI = 0.516–1.142; p < 0.001). Moderator analyses on exercise type revealed significant positive effects for combined exercise interventions (SMD = 1.111; 95% CI = 0.635–1.587; p < 0.001), whereas aerobic training alone failed to show significant effects (SMD = 0.202; 95% CI = −0.045 to 0.449; p = 0.108). Both light-to-moderate intensity exercises (SMD = 0.971; 95% CI = 0.521–1.421; p < 0.001) and moderate-to-vigorous intensity exercises (SMD = 0.779; 95% CI = 0.407–1.152; p < 0.001) significantly improved depressive symptoms with a small difference between the exercise intensities.

Discussion

Our results suggest that physical exercise has significant antidepressant effects in patients with PD. These effects seemed to be more closely associated with exercise type than intensity. Different types of exercise interventions may result in greater benefit and require further investigation.

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Information & Authors

Information

Published In

Neurology®
Volume 100Number 4January 24, 2023
Pages: e377-e387
PubMed: 36220597

Publication History

Received: April 14, 2022
Accepted: September 8, 2022
Published online: October 11, 2022
Published in print: January 24, 2023

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Disclosure

The authors report no disclosures relevant to the manuscript.Go to Neurology.org/N for full disclosures.

Study Funding

This work was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. 2021M3E5D1A02015184). This work was supported by the NRF grant funded by the Korea government (MSIT) (No. 2021R1C1C1011822). This work was supported by a grant from the Ministry of Education and the NRF grant funded by the Korean government (MSIT) (No. 2020S1A5A8041203).

Authors

Affiliations & Disclosures

From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Tae Lee Lee, BS
From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Hanall Lee, MS
From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Do Kyung Ko, BS
From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Beomseok Jeon, MD, PhD
From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
(1)Korea Research-Based Pharmaceutical Industry <br>Association(Travel Grant), <br>(2) Korean Pharmaceutical Manufacturers Association<br>(Travel Grant), <br>(3) Seoul National University(Travel Grant), <br>(4) Seoul National University Hospital(Travel Grant)
Editorial Boards:
1.
1) Clinical Neurology and Neurosciences Report, editor <br>2012.6 -<br><br>(2) BMC Neurology, editor, 2013.5 - 2019.8<br><br>(3) Neurohospitalist, editor, 2012 - 2018<br><br>(4) BioMed Research International, editor, 2013 - 2018<br><br>(5) Journal of Clinical Movement Disorders, editor, 2014 -<br><br>(6) npj Parkinson&#x0092;s Disease, editor, 2014.10 -<br><br>(7) Journal of Clinical Neurosciences, editor, 2016.06 -<br><br>(8) Annals of Indian Academy of Neurology, editor 2018.2 -<br><br>(9) Translational Neurodegeneration, editor, 2018.4 &#x0096;<br><br>(10) Parkinsonism and Related Disorders, associate editor <br>2019.9
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) Abbvie Korea, (2) Peptron
Research Support, Government Entities:
1.
(1) Ministry of Health and Welfare, Korea
Research Support, Academic Entities:
1.
(1) Seoul National University Hospital
Research Support, Foundations and Societies:
1.
(1) Sinyang Cultural Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Nyeonju Kang, PhD
From the Department of Neurology (R.K.), Inha University Hospital, Inha University College of Medicine, Incheon, Korea; Department of Human Movement Science (T.L.L., H.L., D.K.K., N.K.), Incheon National University, Korea; Division of Sport Science (T.L.L., H.L., D.K.K., N.K.), Sport Science Institute & Health Promotion Center, Incheon National University, Korea; Department of Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Korea; and Neuromechanical Rehabilitation Research Laboratory (N.K.), Incheon National University, Korea.
Disclosure
Scientific Advisory Boards:
1.
None
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
None
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
None
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence Dr. Kang [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Peter Hedera, MD, PhD.

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