title: Effects of Resistance Training on Measures of Muscular Strength in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The aim of this systematic review and meta-analysis was to determine the overall effect of resistance training (RT) on measures of muscular strength in people with Parkinson's disease (PD).
  
  
  METHODS
  Controlled trials with parallel-group-design were identified from computerized literature searching and citation tracking performed until August 2014. Two reviewers independently screened for eligibility and assessed the quality of the studies using the Cochrane risk-of-bias-tool. For each study, mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes based on between-group comparisons using post-intervention data. Subgroup analysis was conducted based on differences in study design.
  
  
  RESULTS
  Nine studies met the inclusion criteria; all had a moderate to high risk of bias. Pooled data showed that knee extension, knee flexion and leg press strength were significantly greater in PD patients who undertook RT compared to control groups with or without interventions. Subgroups were: RT vs. control-without-intervention, RT vs. control-with-intervention, RT-with-other-form-of-exercise vs. control-without-intervention, RT-with-other-form-of-exercise vs. control-with-intervention. Pooled subgroup analysis showed that RT combined with aerobic/balance/stretching exercise resulted in significantly greater knee extension, knee flexion and leg press strength compared with no-intervention. Compared to treadmill or balance exercise it resulted in greater knee flexion, but not knee extension or leg press strength. RT alone resulted in greater knee extension and flexion strength compared to stretching, but not in greater leg press strength compared to no-intervention.
  
  
  CONCLUSIONS
  Overall, the current evidence suggests that exercise interventions that contain RT may be effective in improving muscular strength in people with PD compared with no exercise. However, depending on muscle group and/or training dose, RT may not be superior to other exercise types. Interventions which combine RT with other exercise may be most effective. Findings should be interpreted with caution due to the relatively high risk of bias of most studies.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Luisa
authors.initials: L
authors.lastname: Roeder
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia; Extreme Environments Laboratory (EEL), Department of Sport and Exercise Science, Spinnaker Building, Cambridge Road, University of Portsmouth, Portsmouth, PO1 2ER, United Kingdom.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Costello
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; CARRS-Q, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Smith
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Stewart
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; Injury Prevention Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Graham K
authors.initials: GK
authors.lastname: Kerr
mesh_terms: D006801:Humans; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D055070:Resistance Training; D016896:Treatment Outcome