Balance and falls in Parkinson's disease: a meta-analysis of the effect of exercise and motor training.

This systematic review with meta-analysis aimed to determine the effects of exercise and motor training on the performance of balance-related activities and falls in people with Parkinson's disease. Sixteen randomized and quasi-randomized controlled trials that assessed the efficacy of exercise and/or motor training against no intervention or placebo intervention were included. The primary outcome measures were balance-related activity performance (15 trials) and falls (2 trials). The pooled estimate of the effect of exercise and motor training indicated significantly improved balance-related activity performance (Hedges' g, 0.33; 95% confidence interval, 0.11-0.55; P=.003), but there was no evidence of an effect on the proportion of fallers (risk ratio, 1.02; 95% confidence interval, 0.66-1.58, P=.94). Balance-related activity performance improved to a greater extent in the trials of programs involving highly challenging balance training, but the difference in effect sizes was not statistically significant (P=.166). Exercise and motor training can improve the performance of balance-related activities in people with Parkinson's disease. However, further research is required to determine if falls can be prevented in this population.