{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:57:53Z","timestamp":1791291473363,"version":"4.3.0"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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>Upper-limb impairment limits independence in Parkinson\u2019s disease (PD), but the comparative effects and dose\u2013response profiles of exercise modalities remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, CENTRAL, Web of Science, Scopus, and SPORTDiscus were searched from inception to June 20, 2026. Studies that qualified were randomized controlled trials of structured exercise or rehabilitation in adults with PD. Bayesian random-effects network meta-analysis and model-based dose\u2013response network meta-analysis were conducted separately for finger dexterity and upper-limb function. Weekly dose was expressed as metabolic equivalent of task minutes per week (MET\u00b7min\/week), and evidence certainty was assessed using CINeMA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-six reports comprising 1,575 participants were included. Aerobic exercise training (Hedges\u2019\n                      <jats:italic>g<\/jats:italic>\n                      1.46, 95% CrI 0.26\u20132.69) and task-oriented finger-dexterity training (0.96, 0.23\u20131.67) improved finger dexterity versus usual care. Low-certainty evidence suggested that mind\u2013body exercise may improve upper-limb function, although the unusually large estimate (Hedges\u2019\n                      <jats:italic>g<\/jats:italic>\n                      =\u202f6.90, 95% CrI 4.28\u20139.43) was based on only two small trials involving 53 participants in the relevant comparison arms. Given the sparse evidence and local inconsistency in the modality-specific dose\u2013response analysis, this result should be regarded as exploratory and interpreted cautiously. Models fitted to mapped dose nodes suggested an approximately linear association for finger dexterity and diminishing incremental gains for upper-limb function. Predictions toward 1,800 MET\u00b7min\/week partly extended beyond the highest representative dose nodes and remained uncertain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise effects were outcome specific. The findings can inform exercise-modality selection and future dose-ranging trials, but they do not establish an optimal dose or justify a uniform clinical prescription.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261463560<\/jats:ext-link>\n                      , identifier: CRD420261463560.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1964034","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:33:27Z","timestamp":1791290007000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effects and dose\u2013response relationships of exercise for finger dexterity and upper-limb function in Parkinson\u2019s disease: a Bayesian network and model-based dose\u2013response meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Bu-Yu","family":"Liu","sequence":"first","affiliation":[{"name":"School of Physical Education, Hainan Normal University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Xin","family":"Zhuang","sequence":"additional","affiliation":[{"name":"School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Kuan","family":"Zhuang","sequence":"additional","affiliation":[{"name":"School of Physical Education, Hainan Normal University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ruan","sequence":"additional","affiliation":[{"name":"School of Physical Education, Hainan Normal University","place":["Haikou, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","article-title":"Parkinson\u2019s disease","volume":"397","author":"Bloem","year":"2021","journal-title":"Lancet"},{"key":"ref2","volume-title":"Parkinson Disease World Health Organ","year":"2023"},{"key":"ref3","volume-title":"Global Health Estimates 2021: Disease Burden by Cause, Age, Sex, by Country and by Region, 2000\u20132021 Glob Health Estim","year":"2024"},{"key":"ref4","volume-title":"Global Health Estimates 2021: Deaths by Cause, Age, Sex, by Country and by Region, 2000\u20132021 Glob Health Estim","year":"2024"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s 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