{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:18:43Z","timestamp":1791908323406,"version":"4.3.4"},"reference-count":104,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Parkinson\u2019s disease (PD) is a significant neurodegenerative disorder that affects millions of individuals worldwide and currently has limited effective treatment options. Exercise has been proposed as a non-pharmacological intervention to improve both motor and non-motor symptoms in PD. This study aims to systematically review and meta-analyze the impact of exercise interventions on sleep quality and physical functioning in PD patients. A comprehensive search of the literature up to December 15, 2023, identified randomized controlled trials that evaluated exercise interventions in PD patients. The primary outcomes were sleep quality, motor function, balance, gait performance, and quality of life. A total of 62 studies with 3,274 participants were included in the analysis. Exercise interventions led to significant improvements in sleep quality [SMD\u2009=\u2009\u22120.55, 95% CI (\u22120.91, \u22120.18),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009=\u20090.003], motor capability [SMD\u2009=\u2009\u22120.47, 95% CI (\u22120.66, \u22120.28),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009&lt;\u20090.01], balance ability [SMD\u2009=\u20090.53, 95% CI (0.33, 0.74),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009&lt;\u20090.0001], gait performance [TUGT: SMD\u2009=\u2009\u22120.44, 95% CI (\u22120.60, \u22120.29),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009=\u20090.0017; stride velocity: SMD\u2009=\u20090.38, 95% CI (0.15, 0.60),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009=\u20090.001; step length: SMD\u2009=\u20090.32, 95% CI (0.10, 0.54),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009=\u20090.004], and quality of life [SMD\u2009=\u2009\u22120.38, 95% CI (\u22120.73, \u22120.03),\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009=\u20090.04] (\n                    <jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\n                    <\/jats:italic>\n                    &lt;\u20090.05). Exercise is an effective intervention for enhancing sleep quality and improving physical function in PD patients. These findings underscore the importance of incorporating exercise into the management strategies for PD.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0336381","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T18:24:46Z","timestamp":1764181486000},"page":"e0336381","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Exercise: The key to enhancing sleep quality and physical function in Parkinson\u2019s disease? A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"given":"Zhiqin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7470-1764","authenticated-orcid":true,"given":"Pingqing","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"pone.0336381.ref001","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.50.3_Suppl_3.S1","article-title":"An algorithm (decision tree) for the management of Parkinson\u2019s disease: treatment guidelines. American Academy of Neurology","volume":"50","author":"CW Olanow","year":"1998","journal-title":"Neurology"},{"key":"pone.0336381.ref002","doi-asserted-by":"crossref","first-page":"101759","DOI":"10.1016\/j.smrv.2023.101759","article-title":"Sleep and wakefulness disturbances in Parkinson\u2019s disease: A meta-analysis on prevalence and clinical aspects of REM sleep behavior disorder, excessive daytime sleepiness and insomnia","volume":"68","author":"G Maggi","year":"2023","journal-title":"Sleep Med Rev"},{"issue":"7","key":"pone.0336381.ref003","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.3233\/JPD-212749","article-title":"Management of sleep disturbances in Parkinson\u2019s disease","volume":"12","author":"L Sch\u00fctz","year":"2022","journal-title":"J Parkinsons Dis"},{"key":"pone.0336381.ref004","article-title":"Exercise: is it a neuroprotective and if so, how does it work?","author":"MJ Zigmond","year":"2014","journal-title":"Parkinsonism Relat Disord"},{"issue":"5","key":"pone.0336381.ref005","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1212\/01.wnl.0000247740.47667.03","article-title":"Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030","volume":"68","author":"ER Dorsey","year":"2007","journal-title":"Neurology"},{"issue":"9","key":"pone.0336381.ref006","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1038\/nrneurol.2011.107","article-title":"How might physical activity benefit patients with Parkinson disease?","volume":"7","author":"AD Speelman","year":"2011","journal-title":"Nat Rev Neurol"},{"key":"pone.0336381.ref007","doi-asserted-by":"crossref","first-page":"379","DOI":"10.4324\/9781003526308-18","article-title":"Aquatic therapy in rehabilitation","volume-title":"Rehabilitation techniques for sports medicine and athletic training","author":"BJ Hoogenboom","year":"2024"},{"key":"pone.0336381.ref008","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.bandc.2015.07.005","article-title":"Enhancing both motor and cognitive functioning in Parkinson\u2019s disease: aerobic exercise as a rehabilitative intervention","volume":"99","author":"C Duchesne","year":"2015","journal-title":"Brain Cogn"},{"issue":"4","key":"pone.0336381.ref009","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/mds.25787","article-title":"A randomized controlled trial of patient-reported outcomes with tai chi exercise in Parkinson\u2019s disease","volume":"29","author":"F Li","year":"2014","journal-title":"Mov Disord"},{"issue":"3","key":"pone.0336381.ref010","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1123\/apaq.2015-0113","article-title":"Adapted tango for adults with Parkinson\u2019s disease: a qualitative study","volume":"34","author":"WM Holmes","year":"2017","journal-title":"Adapt Phys Activ Q"},{"issue":"7","key":"pone.0336381.ref011","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamaneurol.2019.0534","article-title":"Effects of mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson disease: a randomized clinical trial","volume":"76","author":"JYY Kwok","year":"2019","journal-title":"JAMA Neurol"},{"issue":"11","key":"pone.0336381.ref012","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.parkreldis.2013.06.007","article-title":"The effect of Tai Chi exercise on gait initiation and gait performance in persons with Parkinson\u2019s disease","volume":"19","author":"S Amano","year":"2013","journal-title":"Parkinsonism Relat Disord"},{"key":"pone.0336381.ref013","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3389\/fnagi.2015.00040","article-title":"Lower limb progressive resistance training improves leg strength but not gait speed or balance in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"7","author":"A Tillman","year":"2015","journal-title":"Front Aging Neurosci"},{"key":"pone.0336381.ref014","doi-asserted-by":"crossref","first-page":"796712","DOI":"10.3389\/fnhum.2022.796712","article-title":"Effects of exercise on Parkinson\u2019s disease: a meta-analysis of brain imaging studies","volume":"16","author":"J Li","year":"2022","journal-title":"Front Hum Neurosci"},{"issue":"1","key":"pone.0336381.ref015","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1038\/s41531-022-00418-4","article-title":"A systematic review and meta-analysis on effects of aerobic exercise in people with Parkinson\u2019s disease","volume":"8","author":"K Zhen","year":"2022","journal-title":"NPJ Parkinsons Dis"},{"issue":"4","key":"pone.0336381.ref016","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"151","author":"PRISMA Group","year":"2009","journal-title":"Ann Intern Med"},{"key":"pone.0336381.ref017","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"JAC Sterne","year":"2019","journal-title":"BMJ"},{"issue":"3","key":"pone.0336381.ref018","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"R DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"issue":"13","key":"pone.0336381.ref019","doi-asserted-by":"crossref","first-page":"8042","DOI":"10.3390\/ijerph19138042","article-title":"Comparison of Wuqinxi Qigong with stretching on single- and dual-task gait, motor symptoms and quality of life in Parkinson\u2019s disease: a preliminary randomized control study","volume":"19","author":"Z Li","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"01","key":"pone.0336381.ref020","first-page":"54","article-title":"The application of Wuqinxi combined with low-load exercise in the rehabilitation of Parkinson\u2019s therapy residents","volume":"31","author":"X Kong","year":"2022","journal-title":"Chin J Convalescent Med"},{"issue":"1","key":"pone.0336381.ref021","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s12883-022-02647-9","article-title":"Evaluation of an individualized, tablet-based physiotherapy training programme for patients with Parkinson\u2019s disease: the ParkProTrain study, a quasi-randomised controlled trial","volume":"22","author":"L Wagner","year":"2022","journal-title":"BMC Neurol"},{"key":"pone.0336381.ref022","doi-asserted-by":"crossref","first-page":"8833736","DOI":"10.1155\/2021\/8833736","article-title":"The feasibility and positive effects of wuqinxi exercise on the cognitive and motor functions of patients with Parkinson\u2019s disease: a pilot study","volume":"2021","author":"M Shen","year":"2021","journal-title":"Evid Based Complement Alternat Med"},{"issue":"08","key":"pone.0336381.ref023","first-page":"41","article-title":"Observational study on the therapeutic effect of Tai Chi in improving balance disorders in early-stage Parkinson\u2019s disease patients","volume":"12","author":"H Xiao","year":"2021","journal-title":"Tradition Chin Med Rehabil"},{"key":"pone.0336381.ref024","article-title":"Effects of home-based exercise on motor, non-motor symptoms and health-related quality of life in Parkinson\u2019s disease patients: a randomized controlled trial","author":"P-L Wu","year":"2021","journal-title":"Jpn J Nurs Sci"},{"key":"pone.0336381.ref025","unstructured":"Nuan X. Effects of Innovative Tai Chi training on motor ability and quality of life in patients with early Parkinson\u2019s disease. 2020."},{"issue":"17","key":"pone.0336381.ref026","first-page":"1","article-title":"Clinical analysis of the effects of Tai Chi training on improving balance function and fear of falling in Parkinson\u2019s disease patients","volume":"10","author":"W Deng","year":"2020","journal-title":"J Front Med"},{"issue":"9","key":"pone.0336381.ref027","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1002\/mds.28128","article-title":"A randomized, controlled trial of exercise for Parkinsonian individuals with freezing of gait","volume":"35","author":"C Silva-Batista","year":"2020","journal-title":"Mov Disord"},{"issue":"2","key":"pone.0336381.ref028","first-page":"282","article-title":"Effect of simplified Tai Chi exercise on relieving symptoms of patients with mild to moderate Parkinson\u2019s disease","volume":"60","author":"M Zhu","year":"2020","journal-title":"J Sports Med Phys Fitness"},{"issue":"6","key":"pone.0336381.ref029","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/mds.28009","article-title":"Randomized, controlled trial of exercise on objective and subjective sleep in Parkinson\u2019s disease","volume":"35","author":"AW Amara","year":"2020","journal-title":"Mov Disord"},{"issue":"7","key":"pone.0336381.ref030","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/ggi.13682","article-title":"Low-volume resistance training improves the functional capacity of older individuals with Parkinson\u2019s disease","volume":"19","author":"LC Leal","year":"2019","journal-title":"Geriatr Gerontol Int"},{"key":"pone.0336381.ref031","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ctim.2018.10.023","article-title":"Effects of dual-task aquatic exercises on functional mobility, balance and gait of individuals with Parkinson\u2019s disease: a randomized clinical trial with a 3-month follow-up","volume":"42","author":"AZ da Silva","year":"2019","journal-title":"Complement Ther Med"},{"issue":"16","key":"pone.0336381.ref032","first-page":"2832","article-title":"Nursing quality special management practice based on sports symptoms of patients with Parkinson\u2019s disease","volume":"33","author":"F Liu","year":"2019","journal-title":"Chin Nurs Res"},{"issue":"12","key":"pone.0336381.ref033","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1111\/sms.13528","article-title":"Resistance training reduces depressive symptoms in elderly people with Parkinson disease: a controlled randomized study","volume":"29","author":"TA de Lima","year":"2019","journal-title":"Scand J Med Sci Sports"},{"issue":"03","key":"pone.0336381.ref034","first-page":"124","article-title":"Progressive resistance training combined with pramipexole therapy for improving muscular tension in patients with Parkinson\u2019s disease","volume":"14","author":"J Shen","year":"2019","journal-title":"Neural Injury Funct Reconstr"},{"issue":"5","key":"pone.0336381.ref035","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/ptj\/pzz003","article-title":"Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of freezing of gait in Parkinson disease: a randomized controlled trial","volume":"99","author":"I Clerici","year":"2019","journal-title":"Phys Ther"},{"key":"pone.0336381.ref036","first-page":"1517807","article-title":"Physical activity, fatigue, and sleep in people with Parkinson\u2019s disease: a secondary per protocol analysis from an intervention trial","volume":"2018","author":"S Coe","year":"2018","journal-title":"Parkinsons Dis"},{"issue":"3","key":"pone.0336381.ref037","first-page":"1601","article-title":"Effect of aerobic exercise on depression and insomnia in Egyptian geriatrics Parkinson\u2019s population","volume":"15","author":"TIA Elyazed","year":"2018","journal-title":"Biosci Res"},{"issue":"06","key":"pone.0336381.ref038","first-page":"502","article-title":"Clinical observations on the efficacy of functional strength training with a pullback technique for balance function in Parkinson\u2019s disease patients","volume":"33","author":"Y Yang","year":"2018","journal-title":"Chin J Rehabil Med"},{"issue":"14","key":"pone.0336381.ref039","first-page":"58","article-title":"Observational study on the effects of comprehensive rehabilitation training on balance and gait abilities in Parkinson\u2019s disease patients","volume":"18","author":"L Ma","year":"2018","journal-title":"World Latest Med Inf"},{"issue":"02","key":"pone.0336381.ref040","first-page":"95","article-title":"Effects of Tai Chi exercise on cognition and health-related quality of life in patients with Parkinson\u2019s disease","volume":"33","author":"T Wu","year":"2018","journal-title":"Chin J Rehabil Med"},{"key":"pone.0336381.ref041","doi-asserted-by":"crossref","first-page":"2164956118775385","DOI":"10.1177\/2164956118775385","article-title":"Tai Chi for reducing dual-task gait variability, a potential mediator of fall risk in Parkinson\u2019s disease: a pilot randomized controlled trial","volume":"7","author":"G Vergara-Diaz","year":"2018","journal-title":"Glob Adv Health Med"},{"key":"pone.0336381.ref042","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/s40814-018-0355-8","article-title":"Effects of yoga on oxidative stress, motor function, and non-motor symptoms in Parkinson\u2019s disease: a pilot randomized controlled trial","volume":"4","author":"C Cheung","year":"2018","journal-title":"Pilot Feasibility Stud"},{"issue":"20","key":"pone.0336381.ref043","first-page":"4962","article-title":"Efficacy of Tai Chi training on gait ability and fear of falling in early-stage Parkinson\u2019s disease patients: a clinical study","volume":"38","author":"X Guan","year":"2018","journal-title":"Chin J Gerontol"},{"issue":"8","key":"pone.0336381.ref044","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1590\/0004-282x20180071","article-title":"The effect of resistance training on the anxiety symptoms and quality of life in elderly people with Parkinson\u2019s disease: a randomized controlled trial","volume":"76","author":"RM Ferreira","year":"2018","journal-title":"Arq Neuropsiquiatr"},{"issue":"5","key":"pone.0336381.ref045","doi-asserted-by":"crossref","first-page":"651","DOI":"10.23736\/S1973-9087.17.04572-5","article-title":"Effects of progressive resistance exercise in akinetic-rigid Parkinson\u2019s disease patients: a randomized controlled trial","volume":"53","author":"L Santos","year":"2017","journal-title":"Eur J Phys Rehabil Med"},{"issue":"6","key":"pone.0336381.ref046","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.apmr.2017.01.025","article-title":"Land plus aquatic therapy versus land-based rehabilitation alone for the treatment of balance dysfunction in Parkinson disease: a randomized controlled study with 6-month follow-up","volume":"98","author":"G Palamara","year":"2017","journal-title":"Arch Phys Med Rehabil"},{"issue":"6","key":"pone.0336381.ref047","doi-asserted-by":"crossref","first-page":"825","DOI":"10.23736\/S1973-9087.17.04647-0","article-title":"Effectiveness of aquatic therapy for the control of pain and increased functionality in people with Parkinson\u2019s disease: a randomized clinical trial","volume":"53","author":"S P\u00e9rez de la Cruz","year":"2017","journal-title":"Eur J Phys Rehabil Med"},{"issue":"8","key":"pone.0336381.ref048","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.1519\/JSC.0000000000001685","article-title":"Resistance training improves sleep quality in subjects with moderate Parkinson\u2019s disease","volume":"31","author":"C Silva-Batista","year":"2017","journal-title":"J Strength Cond Res"},{"key":"pone.0336381.ref049","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.gaitpost.2016.11.019","article-title":"Underwater gait analysis in Parkinson\u2019s disease","volume":"52","author":"D Volpe","year":"2017","journal-title":"Gait Posture"},{"issue":"8","key":"pone.0336381.ref050","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1177\/0269215516664122","article-title":"Water-based vs. non-water-based physiotherapy for rehabilitation of postural deformities in Parkinson\u2019s disease: a randomized controlled pilot study","volume":"31","author":"D Volpe","year":"2017","journal-title":"Clin Rehabil"},{"key":"pone.0336381.ref051","unstructured":"Zhu M. The effects and mechanism of TaiChi on physical and mental health of patients with Parkinson\u2019s disease. 2017."},{"issue":"07","key":"pone.0336381.ref052","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.15419\/bmrat.v4i07.200","article-title":"The effect of laughter yoga exercises on anxiety and sleep quality in patients suffering from Parkinson\u2019s disease","volume":"4","author":"A Memarian","year":"2017","journal-title":"Biomed Res Ther"},{"issue":"20","key":"pone.0336381.ref053","first-page":"5121","article-title":"The Impact of Tai Chi on the quality of life of elderly patients with early-stage Parkinson\u2019s disease","volume":"37","author":"F Lu","year":"2017","journal-title":"Chin J Gerontol"},{"issue":"11","key":"pone.0336381.ref054","first-page":"1124","article-title":"Influence of Tai Chi training on balance ability and fear of falling of patients with early Parkinson\u2019s disease","volume":"52","author":"X Guan","year":"2017","journal-title":"Jiangxi Med J"},{"issue":"4","key":"pone.0336381.ref055","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.apmr.2016.12.006","article-title":"Aquatic exercise therapy for people with Parkinson disease: a randomized controlled trial","volume":"98","author":"LM Carroll","year":"2017","journal-title":"Arch Phys Med Rehabil"},{"issue":"9","key":"pone.0336381.ref056","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1017\/S135561771600076X","article-title":"Aerobic Exercise Improves Mood, Cognition, and Language Function in Parkinson\u2019s Disease: Results of a Controlled Study","volume":"22","author":"LJP Altmann","year":"2016","journal-title":"J Int Neuropsychol Soc"},{"issue":"9","key":"pone.0336381.ref057","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1249\/MSS.0000000000000945","article-title":"Resistance Training with Instability for Patients with Parkinson\u2019s Disease","volume":"48","author":"C Silva-Batista","year":"2016","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"pone.0336381.ref058","article-title":"Comparative Effect of Power Training and High-Speed Yoga on Motor Function in Older Patients With Parkinson Disease","volume":"97","author":"M Ni","year":"2016","journal-title":"Arch Phys Med Rehabil"},{"issue":"01","key":"pone.0336381.ref059","first-page":"51","article-title":"Effectiveness of Tai Chi for Parkinson disease","volume":"31","author":"S Ji","year":"2016","journal-title":"Chin J Rehabil Med"},{"issue":"8","key":"pone.0336381.ref060","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1111\/ggi.12571","article-title":"Effect of health Baduanjin Qigong for mild to moderate Parkinson\u2019s disease","volume":"16","author":"C-M Xiao","year":"2016","journal-title":"Geriatr Gerontol Int"},{"issue":"28","key":"pone.0336381.ref061","first-page":"3514","article-title":"Effect of Tai Chi training on walking ability and fear of falling of patients with Parkinson\u2019s disease","volume":"30","author":"X Guan","year":"2016","journal-title":"Chin Nurs Res"},{"key":"pone.0336381.ref062","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40734-015-0020-9","article-title":"Multidisciplinary intensive rehabilitation treatment improves sleep quality in Parkinson\u2019s disease","volume":"2","author":"G Frazzitta","year":"2015","journal-title":"J Clin Mov Disord"},{"issue":"2","key":"pone.0336381.ref063","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1177\/1545968314537559","article-title":"Technology-assisted balance and gait training reduces falls in patients with Parkinson\u2019s disease: a randomized controlled trial with 12-month follow-up","volume":"29","author":"X Shen","year":"2015","journal-title":"Neurorehabil Neural Repair"},{"key":"pone.0336381.ref064","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1097\/PHM.0000000000000351","article-title":"Effects of Tai Chi and multimodal exercise training on movement and balance function in mild to moderate idiopathic Parkinson disease","volume":"94","author":"T-Y Zhang","year":"2015","journal-title":"Am J Phys Med Rehabil"},{"issue":"2","key":"pone.0336381.ref065","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.ctim.2015.01.015","article-title":"Tango for treatment of motor and non-motor manifestations in Parkinson\u2019s disease: a randomized control study","volume":"23","author":"S Rios Romenets","year":"2015","journal-title":"Complement Ther Med"},{"issue":"8","key":"pone.0336381.ref066","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1177\/1545968314565511","article-title":"A randomized controlled trial to reduce falls in people with Parkinson\u2019s disease","volume":"29","author":"ME Morris","year":"2015","journal-title":"Neurorehabil Neural Repair"},{"issue":"01","key":"pone.0336381.ref067","first-page":"77","article-title":"The efficacy of core muscle strengthening training on the rehabilitation of Parkinson\u2019s disease","volume":"36","author":"M Yu","year":"2015","journal-title":"Guangdong Med J"},{"issue":"3","key":"pone.0336381.ref068","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/0269215513507462","article-title":"Leg muscle power is enhanced by training in people with Parkinson\u2019s disease: a randomized controlled trial","volume":"28","author":"SS Paul","year":"2014","journal-title":"Clin Rehabil"},{"issue":"2","key":"pone.0336381.ref069","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/ggi.12082","article-title":"Effect of a multimodal exercise program on sleep disturbances and instrumental activities of daily living performance on Parkinson\u2019s and Alzheimer\u2019s disease patients","volume":"14","author":"CMC Nascimento","year":"2014","journal-title":"Geriatr Gerontol Int"},{"issue":"12","key":"pone.0336381.ref070","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1177\/0269215514536060","article-title":"Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson\u2019s disease: a randomized controlled pilot study","volume":"28","author":"D Volpe","year":"2014","journal-title":"Clin Rehabil"},{"key":"pone.0336381.ref071","first-page":"548240","article-title":"Therapeutic effects of tai chi in patients with Parkinson\u2019s disease","volume":"2013","author":"H-J Choi","year":"2013","journal-title":"Int Scholar Res Notice Neurol"},{"issue":"6","key":"pone.0336381.ref072","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1080\/00222895.2013.834288","article-title":"The effects of adapted tango on spatial cognition and disease severity in Parkinson\u2019s disease","volume":"45","author":"KE McKee","year":"2013","journal-title":"J Mot Behav"},{"issue":"9","key":"pone.0336381.ref073","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1002\/mds.25380","article-title":"A two-year randomized controlled trial of progressive resistance exercise for Parkinson\u2019s disease","volume":"28","author":"DM Corcos","year":"2013","journal-title":"Mov Disord"},{"issue":"4","key":"pone.0336381.ref074","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.gaitpost.2011.12.022","article-title":"Progressive resistance training improves gait initiation in individuals with Parkinson\u2019s disease","volume":"35","author":"CJ Hass","year":"2012","journal-title":"Gait Posture"},{"issue":"6","key":"pone.0336381.ref075","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1056\/NEJMoa1107911","article-title":"Tai chi and postural stability in patients with Parkinson\u2019s disease","volume":"366","author":"F Li","year":"2012","journal-title":"N Engl J Med"},{"issue":"8","key":"pone.0336381.ref076","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.apmr.2011.03.017","article-title":"Aquatic therapy versus conventional land-based therapy for Parkinson\u2019s disease: an open-label pilot study","volume":"92","author":"J Vivas","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"key":"pone.0336381.ref077","doi-asserted-by":"crossref","first-page":"232473","DOI":"10.4061\/2011\/232473","article-title":"Effects of a flexibility and relaxation programme, walking, and nordic walking on Parkinson\u2019s disease","volume":"2011","author":"I Reuter","year":"2011","journal-title":"J Aging Res"},{"issue":"9","key":"pone.0336381.ref078","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1002\/mds.23082","article-title":"The effects of an exercise program on fall risk factors in people with Parkinson\u2019s disease: a randomized controlled trial","volume":"25","author":"NE Allen","year":"2010","journal-title":"Mov Disord"},{"issue":"3","key":"pone.0336381.ref079","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.gaitpost.2008.02.005","article-title":"Tai Chi improves balance and mobility in people with Parkinson disease","volume":"28","author":"ME Hackney","year":"2008","journal-title":"Gait Posture"},{"issue":"4","key":"pone.0336381.ref080","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1007\/s13311-020-00900-y","article-title":"Complementary therapies in Parkinson disease: a review of acupuncture, Tai Chi, Qi Gong, Yoga, and Cannabis","volume":"17","author":"LM Deuel","year":"2020","journal-title":"Neurotherapeutics"},{"key":"pone.0336381.ref081","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1016\/j.neubiorev.2013.04.005","article-title":"Beneficial effects of physical exercise on neuroplasticity and cognition","volume":"37","author":"K H\u00f6tting","year":"2013","journal-title":"Neurosci Biobehav Rev"},{"issue":"06","key":"pone.0336381.ref082","first-page":"789","article-title":"Erk\/MAPK signaling pathway on motor behavior control of basal ganglia","volume":"39","author":"YH W","year":"2023","journal-title":"China J Biochem Mol Biol"},{"key":"pone.0336381.ref083","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3389\/fnagi.2017.00358","article-title":"Exercise-induced neuroprotection of the nigrostriatal dopamine system in Parkinson\u2019s Disease","volume":"9","author":"L Hou","year":"2017","journal-title":"Front Aging Neurosci"},{"issue":"6","key":"pone.0336381.ref084","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/PHM.0b013e31828cd254","article-title":"The beneficial role of intensive exercise on Parkinson disease progression","volume":"92","author":"G Frazzitta","year":"2013","journal-title":"Am J Phys Med Rehabil"},{"issue":"2","key":"pone.0336381.ref085","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/ana.26291","article-title":"Aerobic exercise alters brain function and structure in Parkinson\u2019s disease: a randomized controlled trial","volume":"91","author":"ME Johansson","year":"2022","journal-title":"Ann Neurol"},{"key":"pone.0336381.ref086","first-page":"3257623","article-title":"Effect of exercise on quality of life in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"2020","author":"K Chen","year":"2020","journal-title":"Parkinsons Dis"},{"key":"pone.0336381.ref087","first-page":"2565320","article-title":"Exercise therapies for Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"2020","author":"H-Y Choi","year":"2020","journal-title":"Parkinsons Dis"},{"issue":"2","key":"pone.0336381.ref088","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3233\/NRE-151257","article-title":"Effects of a nordic walking program on motor and non-motor symptoms, functional performance and body composition in patients with Parkinson\u2019s disease","volume":"37","author":"L Cugusi","year":"2015","journal-title":"NeuroRehabilitation"},{"issue":"01","key":"pone.0336381.ref089","first-page":"101","article-title":"Effects of Taiji Quan and Baduanjin on motor function of lower limbs for stroke patients using surface electromyography","volume":"25","author":"H Yang","year":"2019","journal-title":"Chinese J Rehabil Theor Pract"},{"issue":"04","key":"pone.0336381.ref090","first-page":"494","article-title":"Study on the effect of G-EO gait-therapy system on balance function inpatients with Parkinson\u2019s disease","volume":"37","author":"W Ding","year":"2022","journal-title":"Chin J Rehabil Med"},{"key":"pone.0336381.ref091","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/bs.irn.2019.06.003","article-title":"Exercise and Parkinson\u2019s disease","volume":"147","author":"X Xu","year":"2019","journal-title":"Int Rev Neurobiol"},{"issue":"10","key":"pone.0336381.ref092","first-page":"1169","article-title":"Reduction of risk of fall for aging adults participating in Tai Chi and other exercises: a meta-analysis","volume":"28","author":"X Liu","year":"2022","journal-title":"Chin J Rehabil Theor Pract"},{"issue":"02","key":"pone.0336381.ref093","first-page":"230","article-title":"Effect of Taiji Quan on sleep quality of patients with chronic insomnia disorder","volume":"25","author":"Q Zhou","year":"2019","journal-title":"Chin J Rehabil Theor Pract"},{"key":"pone.0336381.ref094","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.parkreldis.2017.05.019","article-title":"The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"41","author":"R Song","year":"2017","journal-title":"Parkinsonism Relat Disord"},{"issue":"6","key":"pone.0336381.ref095","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1177\/1545968315613447","article-title":"Effects of exercise on falls, balance, and gait ability in Parkinson\u2019s disease: a meta-analysis","volume":"30","author":"X Shen","year":"2016","journal-title":"Neurorehabil Neural Repair"},{"issue":"3","key":"pone.0336381.ref096","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1249\/JES.0000000000000189","article-title":"Resistance exercise-induced hypertrophy: a potential role for rapamycin-insensitive mTOR","volume":"47","author":"R Ogasawara","year":"2019","journal-title":"Exerc Sport Sci Rev"},{"issue":"1","key":"pone.0336381.ref097","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S1836-9553(13)70141-3","article-title":"Progressive resistance exercise improves strength and physical performance in people with mild to moderate Parkinson\u2019s disease: a systematic review","volume":"59","author":"LO Lima","year":"2013","journal-title":"J Physiother"},{"issue":"1","key":"pone.0336381.ref098","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/0269215515570381","article-title":"Effectiveness of resistance training on muscle strength and physical function in people with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"30","author":"CLH Chung","year":"2016","journal-title":"Clin Rehabil"},{"issue":"10","key":"pone.0336381.ref099","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.parkreldis.2009.04.009","article-title":"High intensity eccentric resistance training decreases bradykinesia and improves Quality Of Life in persons with Parkinson\u2019s disease: a preliminary study","volume":"15","author":"LE Dibble","year":"2009","journal-title":"Parkinsonism Relat Disord"},{"key":"pone.0336381.ref100","unstructured":"Group APAAP. Australian guidelines for aquatic physiotherapists working in and\/or managing hydrotherapy pools. Australian Physiotherapy Association. 2015."},{"issue":"3","key":"pone.0336381.ref101","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1001\/jama.284.3.342","article-title":"Role of exercise stress testing and safety monitoring for older persons starting an exercise program","volume":"284","author":"TM Gill","year":"2000","journal-title":"JAMA"},{"issue":"9","key":"pone.0336381.ref102","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.pmrj.2009.05.017","article-title":"Aquatic therapy: scientific foundations and clinical rehabilitation applications","volume":"1","author":"BE Becker","year":"2009","journal-title":"PM R"},{"issue":"2","key":"pone.0336381.ref103","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s40520-014-0252-9","article-title":"Differential effects of water-based exercise on the cognitive function in independent elderly adults","volume":"27","author":"D Sato","year":"2015","journal-title":"Aging Clin Exp Res"},{"key":"pone.0336381.ref104","article-title":"Hydrotherapy: application of an aquatic functional assessment scale (AFAS) in aquatic motor skills learning","author":"VL Israel","year":"2014","journal-title":"Am Int J Contemp Res"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T18:25:01Z","timestamp":1764181501000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0336381"}},"subtitle":[],"editor":[{"given":"Imre","family":"Cikajlo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":104,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0336381","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]}}}