Review Article

Exercise and Motor Training in People with Parkinson's Disease: A Systematic Review of Participant Characteristics, Intervention Delivery, Retention Rates, Adherence, and Adverse Events in Clinical Trials

Table 1

Characteristics of the 53 included trials.

First author, year and intervention typeInitial group sizesDisease severityLocation and delivery of experimental interventionDuration of intervention (weeks)Hours of intervention (approx)Supervision (%)Retention (%)Any dropouts related to intervention?Adherence (%)Adverse events occurred

Allen 2010,Mild toFacility, group
exercise OR24moderate+ home individual266510%87.5%Y70%N
control24100%

Ashburn 2007,ModerateHome,
exercise and70individual63318%96%YU (99% of Supervised exercise)N
strategy OR
control72  92%

Bergen 2002,
aerobic
exercise OR
MildFacility,NANRNRM
4 delivery1632100%100%
unclear
control4100%

Blackinton 2002,UMild toFacility,UNRNRM
exercise OR15moderate group + home61566%53%Y
controltotalindividual total

Bloomer 2008,MildFacility,
resistance8delivery88100%75%NUN
training ORunclear
control888%

Braun 2011,Mild toFacility,UNRM
physiotherapymoderatelyindividual or6 + home
+ mental25severegroup + home,6mentalU (100%)88%Y(87%)†‡
practice ORindividualpractice
physiotherapy + relaxation2266 + home relaxationU (100%)82% (88%)†‡

BridgewaterMild toFacility, groupNANRM
1996 (also as [38]),moderate
aerobic and131216 to 22100%100%95%
trunk muscle
training OR
education13124100%U

Burini 2006*,Mild toFacility, groupNRM
aerobic13moderate717100%85%Y87%
exercise OR
Qigong13717100%85%Y88%

Caglar 2005,Mild toFacility, groupNANRM
exercise OR15moderate+ home,9634%100%100%
control15individual

Cakit 2007,Mild toFacility,NRPartial—
treadmill27moderatedelivery88100%78%U2 minor
walking ORunclearcardiac
control2737%

ComellaUMild toFacility,UNRM
1994*,18moderatedelivery89% total
physiotherapytotalunclear412100%UU
OR
control

de Bruin 2010,Mild toHome,
walk with16moderateindividual1319.50%69%Y100%Y—1
music ORthigh
control1765%cramping
1
tiredness

Dereli 2010,Mild toNRM
supervised16moderateFacility,1022.5100%94%Y100%
exercise OR
home exercise
individual;
16home, individual1022.54%94%NR

Dias 2005,Mild toFacility,NANRM
physiotherapy8moderatedelivery4 to 1020100%100%100%
+ cues ORunclear
physiotherapy84 to 1020100%100%100%

Ebersbach 2010,Mild to moderateNRNRM
LSVT BIG20Facility, individual;4 ome XU (100%)100%NA
OR Nordic walking20facility, group;8 XU (100%)95%U
OR home exercise20home, individual4UU95%N
+ all did home, individual

Ellis 2005*Mild toFacility, groupNRM
(also as [44]),moderate
physiotherapy35618100%91%N93%
OR
control3394%N

Fisher 2008,MildFacility,NANRN
treadmill10delivery818100%100%
walking ORunclear
physiotherapy10818100%100%
OR
control10100%

Frazzitta 2009,ModerateFacility,NANRNRM
Treadmill20individual49.5100%100%
walking with
cues OR
physiotherapy2049.5100%100%
with cues

Guo 2009,Mild toFacility, groupNRNRNRM
physiotherapy23moderateeducation and individual812 of therapy100%91%
and educationtherapy
OR
control2190%

Hackney 2007,Mild toFacility,NANRM
Tango OR9Moderategroup1320100%100%100%
exercise101320100%100%100%

Hackney 2008Mild toFacility,NRM
(also as [54]),moderategroup implied
Tai Chi OR1710 to 1320100%76%Y100%
control1681%

Hackney 2009Mild toFacility,Partial—
(also as [54]),moderategroup1 knee
Waltz/foxtrot1910 to 1320100%89%Y100%pain
OR
tango OR1910 to1320100%74%Y100%
control2085%

Hackney 2010,Mild toFacility, groupNRM
partnered19moderate1020100%79%Y100%
tango OR
nonpartnered201020100%80%Y100%
tango

Hass 2007,Mild toFacility,NANRY—1
resistance10moderatedelivery1212100%100%muscle
training +unclearsoreness
supplementand 1
ORShoulder
resistance101212100%100%pain
training +
placebo

Hirsch 2003,Mild toFacility,
balance and9moderatedelivery1022.5100%67%Y89%Y—1
resistanceunclearinguinal
training ORhernia
balance91015100%100%92%
training

Keus 2007,Mild toFacility,NA
physiotherapy14moderatelyindividual1011 to 15100%100%63%N
OR control13severe92%

Kurtais 2008,Mild toFacility,NRNRM
treadmill13 moderatedelivery612 +U (100%)92%Y
walking ORunclear +home X
home,
control14individual86%

Lehman 2005a,MildFacility implied,NANRNRM
walk with5delivery unclear25100%100%
verbal cues
OR control
6100%

Mak 2008,Mild toFacilityNRNRM
cued sit to21moderateImplied,44100%90%U
stand ORdelivery
OR exercise21unclear46100%90%U
control1878%

MarcheseUMild toFacility,UNRNRNRM
2000,20moderateindividual +
physiotherapytotalhome,618 +U (100%)‡
ORindividualhome X
physiotherapy618 +U (100%)‡
with cueshome X

Miyai 2000*,Mild toFacility,NANRNRM
treadmill5moderateindividual46100%100%
walking OR
physiotherapy546100%100%

Miyai 2002,Mild toFacility,NRNRM
treadmill12moderateindividual46100%92%N
walking OR
physiotherapy1246100%75%N

Morris 2009,Mild toFacility,NANRM
movement14moderateindividual2 Up to 12100%100%88% of
strategies ORmaximum
sessions
exercises14 2Up to 12100%100%81% of
maximum
sessions

Müller 1997,Mild toLocation andNRNRNRM
behavioural15moderatedelivery1030100%U
therapy ORunclear
nonspecific141030100%U
exercises and information

Nieuwboer 2007*
(also as [61, 73]),
Mild to moderateHome,
individual
Partial—
no falls
wearing
activity
monitor
cueing7634.5100%99%N100%
training OR
control77100%

PacchettiMild toFacility, groupUNRNRNRM
2000,moderate
physiotherapy161319.5100%
OR
music therapy161326100%

Palmer 1986,Mild toFacility, groupNANRNRM
exercise OR7moderately1236100%100%
seated karate7severe1236100%100%

Pelosin 2010,Mild toFacility,NANRNRM
physiotherapy9moderatedelivery412100%100%
with FOGunclear
strategies OR
physiotherapy9412100%100%

Protas 2005,Mild toFacility,NANRM
treadmill9moderateindividual824100%100%100%
walking
and step
training OR
control9100%

QutubuddinMild toFacility,NRM
2007,moderatedelivery
computerized12unclear +81820%75%UU
dynamic home,
posturographyindividual
OR
physiotherapy1081820%60%UU

Ridgel 2009,Mild toFacility,NANRNRM
forced cycling5moderatedelivery824100%100%
ORunclear
self-paced5824100%100%
cycling

Sage 2009,Mild toFacility,NRM
aerobic17moderategroup10 to 1218100%76%Y86.8%
exercise OR
SAFEx OR2110 to 1220 to 34100%86%Y92.9%
control15100%

Sage 2010,Mild toFacility,NANRM
SAFEx OR15moderategroup1236100%100%100%
non-SAFEx141236100%100%100%

SchenkmanMild toLocation
1998,moderateunclear,
exercise OR27individual10 to 1322.5 to 30100%85%U100%†N
control2496%

Schmitz-Mild toFacility groupNRNRM
Hübsch 2006,moderately+ home
Qigong OR32severeindividual2416 + home X66%91%Y
control2487.5%

Smania 2010,ModerateFacility,NRNRM
balance33toindividual717.5100%85%Y
training ORmoderately
general31severe717.5100%87%Y
exercises

StallibrassMild toFacility,NRM
2002,moderateindividual
Alexander321216100%91%Y99%
technique
OR
massage OR31121693%97%
control30100%

Tamir 2007,Mild toFacility,NRPartial—
exercise + imagery12moderatedelivery1224 +U (100%)92%U2 cardiac
ORunclear +home Xproblems
exercise11home, individual12 XU (100%)91%U

Thaut 1996,Mild toHome,NA
walk with15moderateindividual310.514%100%100%Y—1 fall
auditory cues
OR
walk without11310.514%100%100%
cues OR
control11100%

Toole 2000,Mild toFacility,NRNRM
exercise OR6moderatelydelivery1030100%67%N
control5severeunclear60%

Toole 2005,UMild toFacility,NRNR 99%NRM
treadmill 23moderatelydelivery66100%overall
walking withtotalsevereunclear
body weight
support OR
treadmill66100%
walking with
weights OR
treadmill66100%
walking

Yang 2010,Mild toFacility,
downhill16moderatedelivery46100%94%Y100%N
treadmillunclear
walking OR
conventional1746100%88%Y100%N
therapy

Yousefi 2009,Mild toFacility,NANRNRM
exercise OR12moderategroup1040100%100%
education121040100%

Supervision: the number of intervention sessions supervised expressed as a percentage of the number of sessions prescribed; retention: the number of participants who completed the trial (i.e., undertook a post-intervention assessment but excluding follow-up) expressed as a percentage of the number of participants who began the trial; adherence: the number of intervention sessions participants attended expressed as a percentage of the number of intervention sessions prescribed; Y: yes; N: no; NA: not applicable; U: unclear—insufficient information to categorize; NR: not reported; NRM: not reported to be monitored; X: exercise; FOG: freezing of gait; SAFEx: sensory attention focused exercise; *cross-over trial;data only for participants who completed the trial;data only for the facility component of the intervention;apart 2 of trial only.