Effect of Proprioceptive Training Compared With Other Interventions for Upper Limb Deficits in People With Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Kavinda T Malwanage; Thusharika D Dissanayaka; Natalie E Allen; Serene S Paul

doi:10.1016/j.apmr.2023.10.016

Effect of Proprioceptive Training Compared With Other Interventions for Upper Limb Deficits in People With Parkinson Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Arch Phys Med Rehabil. 2023 Nov 10:S0003-9993(23)00611-1. doi: 10.1016/j.apmr.2023.10.016. Online ahead of print.

Authors

Kavinda T Malwanage¹, Thusharika D Dissanayaka², Natalie E Allen³, Serene S Paul³

Affiliations

¹ Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka. Electronic address: kavindaahs@ahs.pdn.ac.lk.
² Department of Physiotherapy, Monash University, Frankston, Australia.
³ Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.

PMID: 37951376
DOI: 10.1016/j.apmr.2023.10.016

Abstract

Objective: This systematic review and meta-analysis aimed to determine the efficacy of proprioceptive training on hand dexterity, upper limb function, and quality of life (QoL) in people with Parkinson disease (PD) compared with no or other active interventions.

Data sources: Medline PubMed, Cochrane Library, CINAHL, PEDro, and Web of Science databases were searched to identify published studies until February 2023.

Study selection: Peer-reviewed English publications of randomized controlled trials (RCTs) of proprioceptive training conducted among people with PD.

Data extraction: Study characteristics, exercise program type and dosage, outcome of interest, and between-group comparisons of post-test results of intervention and comparison groups.

Data synthesis: Eight RCTs were included, involving 344 people with PD. Six RCTs contributed to meta-analyses. There was very low certainty of evidence that proprioceptive training may improve dominant hand (standard mean difference [SMD] 0.34, 95% CI 0.08-0.60, P=.01) and non-dominant hand (SMD 0.36, 95% CI 0.10-0.63, P<.01) fine motor dexterity, and dominant hand gross manual dexterity (SMD 1.73, 95% CI 0.30-3.16, P=.02), following 2-8 weeks of proprioceptive training. There was no evidence of effects on non-dominant hand gross manual dexterity, upper limb function, and QoL after proprioceptive training.

Conclusions: Findings regarding the effect of proprioceptive training on hand dexterity in the short-term are inconclusive. The small sample size likely limited effect detection. Future large RCTs should compare proprioceptive training with no intervention and perform comprehensive biomechanical analysis to gain a clearer idea of its effects. Incorporating longer-duration proprioceptive training programs is also recommended to investigate long-lasting effects.

Keywords: Fine motor dexterity; Gross manual dexterity; Parkinson's disease; Proprioceptive training; Quality of life.

Publication types

Review