{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:02:56Z","timestamp":1784836976275,"version":"3.55.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"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:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterise the dose response relationship between exercise and depressive symptoms in middle aged and older adults with Parkinson disease using a continuous modelling framework and to compare structural differences across exercise modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, Cochrane Library and APA PsycINFO were searched to 19 February 2026. Exercise dose was standardised as MET-minutes per week. A Bayesian network meta-regression model was used to estimate continuous dose\u2013response relationships. Evidence certainty was assessed using GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five RCTs were included. Overall exercise dose showed a significant non-linear association with reduced depressive symptoms in middle-aged and older adults with Parkinson disease. Beneficial effects were sustained between 110 and 890 MET-minutes per week, peaking at 560 MET-minutes per week (effect size 0.48, 95% credible interval 0.22\u20130.80), with an optimal range of 440\u2013670 MET-minutes per week. Effects were not stable at 1000 MET-minutes per week. Modality analyses indicated that exercise combined with cognitive training and mind\u2013body exercise demonstrated consistent benefits within moderate to moderately high dose ranges, both peaking at 560 MET-minutes per week. Aerobic cycling, functional training, and multicomponent training showed no stable significant dose range, whereas walking reached significance only at \u2265670 MET-minutes per week with wide credible intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise in middle-aged and older adults with Parkinson disease and comorbid depression exhibits a structured non-linear dose\u2013response pattern with a defined optimal range, and modality-specific differences indicate that therapeutic effects depend on both quantitative dose and qualitative task characteristics, providing a quantitative basis for precision exercise prescription.<\/jats:p>\n                  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