Effects of aerobic exercise on respiratory and cardiovascular function and associated barriers in Parkinson’s disease: a narrative review of randomized controlled trials

Parkinson’s disease (PD) patients benefit from aerobic exercise, but cardiovascular impairments may limit participation and outcomes. This review aims to investigate the effect of aerobic exercise on respiratory function, cardiopulmonary fitness, autonomic cardiovascular function and functional capacity in individuals with PD. A narrative review of randomized controlled trials (RCTs) was conducted using PubMed, PEDro, and Scopus databases. Studies examining cardiovascular responses to aerobic exercise in PD were included and five RCTs were analyzed. Aerobic exercise improved respiratory pressures and some markers of cardiovascular function, but limitations remained. Cardiovascular barriers included autonomic dysfunction, reduced cardiopulmonary fitness, and respiratory muscle weakness. Aerobic exercise can produce beneficial effects on respiratory muscle strength, and blood pressure regulation in individuals with PD. However, persistent cardiovascular impairments, including autonomic dysfunction and limited cardiopulmonary fitness, continue to restrict full exercise benefits. Tailored interventions and comprehensive assessments are necessary to maximize safety and therapeutic benefits.