Article

Cognitive impairments are highly prevalent in Parkinson's disease (PD) and can
substantially affect a patient's quality of life.
These impairments remain
difficult to manage with current clinical therapies, but exercise has been
identified as a possible treatment. The objective of this systematic review was
to accumulate and analyze evidence for the effects of exercise on cognition in
both animal models of PD and human disease. This systematic review was conducted
according to the Preferred Reporting Items for Systematic reviews and
Meta-Analyses (PRISMA) statement. Fourteen original reports were identified,
including six pre-clinical animal studies and eight human clinical studies. These
studies used various exercise interventions and evaluated many different outcome
measures; therefore, only a qualitative synthesis was performed. The evidence
from animal studies supports the role of exercise to improve cognition in humans
through the promotion of neuronal proliferation, neuroprotection and
neurogenesis. These findings warrant more research to determine what roles these
neural mechanisms play in clinical populations. The reports on cognitive changes
in clinical studies demonstrate that a range of exercise programs can improve
cognition in humans. While each clinical study demonstrated improvements in a
marker of cognition, there were limitations in each study, including
non-randomized designs and risk of bias. The Grading of Recommendations
Assessment, Development and Evaluation (GRADE) system was used and the quality of
the evidence for human studies were rated from "low" to "moderate" and the
strength of the recommendations were rated from "weak" to "strong". Studies that
assessed executive function, compared to general cognitive abilities, received a
higher GRADE rating. Overall, this systematic review found that in animal models
exercise results in behavioral and corresponding neurobiological changes in the
basal ganglia related to cognition. The clinical studies showed that various
types of exercise, including aerobic, resistance and dance can improve cognitive
function, although the optimal type, amount, mechanisms, and duration of exercise
are unclear. With growing support for exercise to improve not only motor
symptoms, but also cognitive impairments in PD, health care providers and policy
makers should recommend exercise as part of routine management and
neurorehabilitation for this disorder.

Langue : ANGLAIS