Review Article

Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review

Table 3

Papers’ key features.

Author and yearType of studyMethod to assess studies’ qualityFindingLimits

Saltychev et al. [27]Systematic review and meta-analysis (12 RCTs)Cochrane Collaboration’s domain-based evaluation frameworkNo evidence for the superiority of PRT compared to other physical trainingSome relevant studies could remain undetected because of the uncertain definition of PRT

Tillman et al. [28]Systematic review and meta-analysis (7 RCTs)PEDro scaleOn measures of gait and balance no evidence to support or refute PRT prescription; in conjunction with balance and task-specific functional training to improve these measuresThe reduced sample size, which has been selected for the feasibility of conducting a one-to-one, 6-week exercise intervention.

Chung et al. [29]Systematic review and meta-analysis (7 RCTs)PEDro scalePRT (2-3 times per week, 8–10 weeks) can enhance strength, balance and motor symptoms in early—moderate PD.No blinding of subjects, intervention therapist and outcome assessors in the most of the RCTs.
Outcome evaluation over short-term (8–14 weeks)

Roeder et al. [30]Systematic review and meta-analysis (9papers)2 review authors using a customized formCombining RT with other form of physical exercise could be most effective.
Not enough data available to evidence-based guidelines for resistance training prescription
Published reports did not provide sufficient details for judgment, then bias from selective reporting of results and from allocation concealment was difficult to determine;
Since much was unknown about the quality of most included studies, it impacts on conclusions drawn from this review which are not definitive.

Lima et al. [22]Systematic review and meta—analysis (2 RCTs and 2 QRCTs.).PEDro scaleEvidence to support PRT prescription in mild/moderate PD’s patients and to implemented it as an ordinary therapy in PD.Only 4 studies included

Cruisckshank et al. [31]Systematic review and meta-analysis (6RCTs + 3 non-RCTs about PD and 5RCTs + 2 non-RCTs about MS)PEDro scaleBenefit in strength after RT, it has a positive effect on clinical disease progression and mobility.
High-quality trials are needed.
The heterogeneity of interventions and study outcomes in PD and MS trials

Uhrbrand et al. [32]Systematic review and meta-analysis (9RCTs)PEDro scaleStrong evidence in favor of muscle strength improving in PD.
Inconsistent findings are about balance, walking performance and quality of life improving.
PRT may positively impact UPDRS-III and quality of life.
Small sample size; short-term interventions (≤12 settimane)

Brienesse and Emerson [21]Systematic review (3 RCTs and 2 non-RCTs.)Modified version of PEDro scaleRCTs with a standardized and thorough reporting of intervention and functional outcomes are needed.Methodological limitation in available papers (RCTs do not satisfy all of quality criteria); not well RT description/inadequate description of the training protocol.

RCTs (randomized control trials), UPDRS-III = Unified Parkinson's Disease Rating Scale-III, MS = Multiple Sclerosis., PD = Parkinson disease, PRT = progressive resistance training, RT = resistance training.