Sustained effects of physiotherapy interventions on balance, gait and general motor function in patients with Parkinson’s disease: a systematic review and meta-analysis

Background and purpose: Balance and gait problems pose a significant burden in Parkinson’s disease (PD) and are often poorly treated with levodopa. Furthermore, available pharmacological treatments in PD provide only symptomatic relief and no disease-modulatory therapy has been established so far. Since most studies report only on immediate post-intervention effects of physiotherapy treatments in PD, it is not clear whether frequently observed positive effects persist over time. The purpose was to summarize evidence of mid- and long-term impact of various physiotherapeutic interventions on improving dynamic balance and gait, as well as general motor function in patients with Parkinson’s disease. Method: A systematic search was conducted across the PubMed, Cochrane Library and Scopus databases to identify controlled clinical trials published from 2000-2025 which included assessments of sustained effects of various exercise interventions in PD (lasting ≥ 3 months after completion of the exercise program). Where appropriate, we conducted meta-analyses on commonly used measures of dynamic balance like TUG (Timed Up and Go) Test or BBS (Berg Balance Scale), gait ability like 6MWT and on UPDRS-III scores for overall motor function. We focused on analyses of change scores from baseline to follow-up assessment. Studies that could not enter a meta-analysis are presented in a narrative manner