title: Progressive resistance training in Parkinson's disease: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate if there is evidence on effectiveness of progressive resistance training in rehabilitation of Parkinson disease.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Central, Medline, Embase, Cinahl, Web of Science, Pedro until May 2014. Randomised controlled or controlled clinical trials. The methodological quality of studies was assessed according to the Cochrane Collaboration's domain-based evaluation framework.
  
  
  RESULTS
  random effects meta-analysis with test for heterogeneity using the I² and pooled estimate as the raw mean difference.
  
  
  METHODS
  Adults with primary/idiopathic Parkinson's disease of any severity, excluding other concurrent neurological condition.
  
  
  METHODS
  Progressive resistance training defined as training consisting of a small number of repetitions until fatigue, allowing sufficient rest between exercises for recovery, and increasing the resistance as the ability to generate force improves.
  Progressive resistance training versus no treatment, placebo or other treatment in randomised controlled or controlled clinical trials.
  
  
  METHODS
  Any outcome.
  
  
  RESULTS
  Of 516 records, 12 were considered relevant. Nine of them had low risk of bias. All studies were randomised controlled trials conducted on small samples with none or 1 month follow-up after the end of intervention. Of them, six were included in quantitative analysis. Pooled effect sizes of meta-analyses on fast and comfortable walking speed, the 6 min walking test, Timed Up and Go test and maximal oxygen consumption were below the level of minimal clinical significance.
  
  
  CONCLUSIONS
  There is so far no evidence on the superiority of progressive resistance training compared with other physical training to support the use of this technique in rehabilitation of Parkinson's disease.
  PROSPERO 2014:CRD42014009844.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Saltychev
authors.affiliation: Satakunta University of Applied Sciences, Pori, Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Bärlund
authors.affiliation: School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Paltamaa
authors.affiliation: Turku University of Applied Sciences, Turku, Finland.
authors.forename: Niina
authors.initials: N
authors.lastname: Katajapuu
authors.affiliation: Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Laimi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010300:Parkinson Disease / Q000534:rehabilitation*; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
keywords: GENERAL MEDICINE (see Internal Medicine); REHABILITATION MEDICINE