Correction to: Neurotherapeutics https://doi.org/10.1007/s13311-020–00904-8
This Correction is to update the published article Schootemeijer et al. [1] and address concerns raised in meta-analyses.
We would like to correct minor errors in the meta-analyses on cardiorespiratory fitness, motor symptoms and quality of life in people with Parkinson’s disease (PD) and state that these corrections have a minor impact on our conclusions.
In some analyses, we erroneously used standard errors instead of standard deviations. In addition, multiple interventions from the same studies were used separately while comparing to the same control group, thereby increasing the weight of the control group. We have now pooled the interventional groups reported in Schenkman et al. [2] and Shulman et al. [3] and calculated the adjusted mean, standard deviation and sample sizes according to Higgins et al. [4]. These changes impacted the results of the previous analyses, which have now been corrected (see replacement Figs. 2–4).
The positive effect of aerobic exercise on physical fitness is still supported by the corrected meta-analysis: the aerobic exercise group showed a higher physical fitness during a maximal graded exercise test (VO2max) at the post-assessment compared to the non-exercise or resistance exercise control groups (mean difference (MD) [95% CI]: 1.82 [0.50; 3.14], Z = 2.70, p = 0.007) (Fig. 2).
The effect of aerobic exercise on PD motor symptoms ((MDS)-UPDRS) in the off medication state is no longer significant in the adjusted analysis at post-assessment compared to the non-aerobic control group (MD [95% CI]: -0.19 [-0.42; 0.03], Z = 1.66, p = 0.10) (Fig. 3B). Although the overall effect was not significant, all studies reported a beneficial effect. The results that we now present are in line with a recent review on this topic [5]. Other corrections did not affect the conclusions. No significant difference was observed between the aerobic exercise group and a non-aerobic control group for PD motor symptoms in the medication ON state (MD [95% CI]: -0.07 [-0.29; 0.15], Z = 0.63, non-significant) (Fig. 3A) and for health-related quality of life (MD [95% CI]: -0.10 [-2.56; 2.36], Z = 0.08, non-significant) (Fig. 4).
We conclude that aerobic exercise offers generic health benefits, improves physical fitness, and shows a trend towards a positive effect on motor symptoms in people with PD. More research is needed to definitively establish the effect of aerobic exercise on motor- and non-motor symptoms and health-related quality of life.
References
Schootemeijer S, van der Kolk NM, Bloem BR, de Vries NM. Current Perspectives on Aerobic Exercise in People with Parkinson's Disease. Neurotherapeutics. 2020.
Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, et al. Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial. JAMA Neurol. 2018;75(2):219–26.
Shulman LM, Katzel LI, Ivey FM, Sorkin JD, Favors K, Anderson KE, et al. Randomized clinical trial of 3 types of physical exercise for patients with Parkinson disease. JAMA Neurol. 2013;70(2):183–90.
Higgins JP, Li T, Deeks JJ. Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 62 (updated February 2021): Cochrane. 2021.
Gamborg M, Hvid LG, Dalgas U, Langeskov-Christensen M. Parkinson's disease and intensive exercise therapy - An updated systematic review and meta-analysis. Acta Neurol Scand. 2022.
Acknowledgements
We wish to thank Dr. Hvid, Dr. Dalgas and Dr. Langeskov-Christensen for pointing out important errors in our published article.
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Schootemeijer, S., van der Kolk, N.M., Bloem, B.R. et al. Correction to: Current Perspectives on Aerobic Exercise in People with Parkinson’s Disease. Neurotherapeutics 19, 683–685 (2022). https://doi.org/10.1007/s13311-022-01219-6
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DOI: https://doi.org/10.1007/s13311-022-01219-6