{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:41:57Z","timestamp":1791013317846,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with Parkinson\u2019s disease (PD) often experience impaired gait stabilization, increased risk of falls, and postural control disorders. Although drug and surgical treatments can partially alleviate symptoms, non-pharmacological interventions (such as physical therapy) have become a research focus due to their safety and multi-system benefits. This study used a network meta-analysis to compare the efficacy of seven types of physical therapy in improving motor dysfunction in PD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The system searched databases such as PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) to collect relevant randomized controlled trials (RCTs) published between 2008 and 2024. The study included seven different types of exercise intervention therapies, including RPT, AE, PCT, MBET, TCRT, SSMT, and RTRT. The primary outcome measures included gait stabilization, fall risk, and postural control. Statistical analysis was performed using Stata 18.0 software, with effect sizes combined using a random-effects model. The effects of different exercise interventions were assessed using a network meta-analysis model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In terms of gait stabilization, MBET ranked highest (SUCRA\u202f=\u202f83.1%), but a direct comparison with RPT showed an SMD of \u22120.32 (95% CI: \u22120.83 to 0.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05), with no statistically significant difference. TCRT was significantly superior to RPT (SMD\u202f=\u202f\u22122.42, 95% CI: \u22123.79 to \u22121.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), with a SUCRA of 69.0%. There was no significant difference between SSMT and RPT (SMD\u202f=\u202f\u22120.48, 95% CI: \u22121.03 to 0.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05), but SUCRA ranked third (60.4%). The Egger test indicated moderate bias (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.020), potentially overestimating the effect size by 15\u201320%. For fall risk: RPT was the most effective (SUCRA\u202f=\u202f97.4%) and significantly superior to RTRT (SMD\u202f=\u202f1.11, 95% CI: 0.66\u20131.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), MBET ranked second (SUCRA\u202f=\u202f69.7%), and was significantly more effective than PCT (SMD\u202f=\u202f\u22126.14, 95% CI: \u22127.86 to \u22124.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). AE ranked third with SUCRA\u202f=\u202f52.2%, showing a significant difference compared to TCRT (SMD\u202f=\u202f0.40, 95% CI: 0.01\u20130.79,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.05). No significant bias was observed (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.760). Postural control: PCT was the most effective (SUCRA\u202f=\u202f92.4%), significantly superior to RTRT (SMD\u202f=\u202f3.90, 95% CI: 1.93 to 5.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). RTRT (resistance training) ranked second (SUCRA\u202f=\u202f79.3%), but there was no significant difference compared with MBET (SMD\u202f=\u202f0.40, 95% CI: \u22120.32 to 1.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). RPT (SUCRA\u202f=\u202f69.5%), but in direct comparisons, MBET was significantly superior to RPT (SMD\u202f=\u202f\u221223.50, 95% CI: \u221232.69 to \u221214.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are differences in the efficacy of different exercise interventions: MBET, TCRT, and SSMT are more effective in stabilizing gait; RPT, MBET, and AE are more effective in reducing fall risk; and PCT and RTRT are most effective in improving postural control. Clinicians can select the most appropriate intervention based on patient needs. It should be noted that there is moderate publication bias in gait stabilization. Future studies should expand the scope of their searches and include unpublished data to optimize the quality of evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1706561","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T17:03:35Z","timestamp":1764954215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A comparative meta-analysis of seven types of exercise-based physical therapy for gait stabilization, fall risk, and postural control in Parkinson\u2019s disease patients"],"prefix":"10.3389","volume":"16","author":[{"given":"Guojun","family":"Tong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianjie","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"CD013856","DOI":"10.1002\/14651858.CD013856.pub3","article-title":"Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis","volume":"4","author":"Ernst","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1187325","DOI":"10.3389\/fendo.2023.1187325","article-title":"Exercise for prevention of falls and fall-related injuries in neurodegenerative diseases and aging-related risk conditions: a meta-analysis","volume":"14","author":"Feng","year":"2023","journal-title":"Front Endocrinol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3233\/JPD-223536","article-title":"Effects of Oral levodopa on balance in people with idiopathic Parkinson's disease","volume":"13","author":"Leroy","year":"2023","journal-title":"J Parkinsons Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.jphys.2024.06.004","article-title":"Walking training with auditory cueing improves walking speed more than walking training alone in ambulatory people with Parkinson's disease: a systematic review","volume":"70","author":"Nascimento","year":"2024","journal-title":"J Physiother"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1186\/s12877-021-02446-w","article-title":"Evidence of disease severity, cognitive and physical outcomes of dance interventions for persons with Parkinson's disease: a systematic review and meta-analysis","volume":"21","author":"Ismail","year":"2021","journal-title":"BMC Geriatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2433","DOI":"10.4103\/0366-6999.164925","article-title":"Long-term efficacy of subthalamic nucleus deep brain stimulation in Parkinson's disease: a 5-year follow-up study in China","volume":"128","author":"Jiang","year":"2015","journal-title":"Chin Med J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1002\/mds.26712","article-title":"Unmasking levodopa resistance in Parkinson's disease","volume":"31","author":"Nonnekes","year":"2016","journal-title":"Mov Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e037632","DOI":"10.1136\/bmjopen-2020-037632","article-title":"Diagnosis, treatment and management of apathy in Parkinson's disease: a scoping review","volume":"10","author":"Mele","year":"2020","journal-title":"BMJ Open"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"CD013856","DOI":"10.1002\/14651858.CD013856.pub2","article-title":"Physical exercise for people with Parkinson's disease: a systematic review and network meta-analysis","volume":"1","author":"Ernst","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1136\/bjsports-2016-096547","article-title":"Exercise to prevent falls in older adults: an updated systematic review and meta-analysis","volume":"51","author":"Sherrington","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1056\/NEJMoa1107911","article-title":"Tai chi and postural stability in patients with Parkinson's disease","volume":"366","author":"Li","year":"2012","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"31","DOI":"10.17761\/ijyt.24.1.377526054663236k","article-title":"Measuring the effect of an eight-week adaptive yoga program on the physical and psychological status of individuals with Parkinson's disease. 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