Effort training in Parkinson's disease: a systematic review.

Objective: Physical therapy strategies have recently proved their efficacy in the field of Parkinson's disease management. The purpose of this paper was to access the efficacy and the limits of aerobic training and strength training included in physical rehabilitation programs and to define practical modalities.

Method: A comprehensive search on Pubmed and Cochrane databases was made.

Results: Five literature revues and thirty one randomised trials have been selected. Exercise training improves aerobic capacities, muscle strength, walking, posture and balance parameters. Rehabilitation programs should begin as soon as possible, last several weeks and be repeated. They should include aerobic training on bicycle or treadmill and a muscle strengthening program.

Conclusion: There is evidence that aerobic and strength training improve physical habilities of patients suffering from Parkinson's Disease. Rehabilitation programs should be discussed with the patient, taking in account his difficulties and his physical capacities. Two questions are debatable: exercise intensity and phase ON / phase OFF timing.