Evidence mapPaperPMID 41876558Full record

ArticleNPJ Parkinson's disease2026

Physiotherapy interventions for balance impairments in Parkinson's disease: evidence from a systematic review and dose-response meta-analysis.

Rebecca Cardini, Elisa Gervasoni, Stefano Giannoni-Luza, Anna Cavalca, Alessia Piva, Davide Cattaneo, Elisa Pelosin, Tommaso Bocci, Sara Marceglia, Alberto Priori and 1 more

Abstract read
In one paragraph

Article in NPJ Parkinson's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Rebecca CardiniIRCSS Fondazione Don Carlo Gnocchi, Milano, Italy.
Elisa GervasoniIRCSS Fondazione Don Carlo Gnocchi, Milano, Italy. egervasoni@dongnocchi.it.
Stefano Giannoni-LuzaCenter for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Puglia, Italy.
Anna CavalcaDepartment of Clinical and Experimental Sciences, University of Brescia, Piazza del Mercato, Brescia, Italy.
Alessia PivaDepartment of Clinical and Experimental Sciences, University of Brescia, Piazza del Mercato, Brescia, Italy.
Davide CattaneoIRCSS Fondazione Don Carlo Gnocchi, Milano, Italy.
Elisa PelosinDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
Tommaso BocciAldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy.
Sara MarcegliaAldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy.
Alberto PrioriAldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy.
Matteo GuidettiAldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy.

Funding

Ministero della Salute Ricerca Corrente
6 · The paper itself

Abstract

Balance impairments are among the most disabling symptoms of Parkinson and are often poorly responsive to pharmacological therapy. Physiotherapy (PT) is a key non-pharmacological intervention to improve postural control, though optimal exercise characteristics and dose remain unclear. We conducted a systematic review and dose-response meta-analysis to evaluate PT's effectiveness on balance in people with Parkinson's disease (PwPD) and define a dose-response relationship. A systematic search of PubMed/MEDLINE, EMBASE, and Web of Science was done from March-April 2024 and updated in February 2025. Eligibility criteria comprised RCTs or cross-over studies included adults with idiopathic PD receiving exercise targeting balance. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias tool for randomized trials (RoB 2.0). Thirty studies (n participants = 2,932; mean ± SD age = 69.3 ± 4.0 years; mean ± SD disease duration = 6.7 ± 1.6 years; mean ± SD Hoehn & Yahr = 2.3 ± 0.5) were included. Balance outcomes were Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go (TUG), Berg Balance Scale (BBS), Unified PD Rating Scale (UPDRS-III), and Sensory Organization Test (SOT). Physiotherapy led to moderate balance improvements (SMD = 0.56, 95%CI 0.38-0.74), with balance-specific training showing the greatest effect (SMD = 0.64, 95%CI 0.35-0.93). No clear linear dose-response was found between training volume and effect size. Subgroup analyses confirmed consistent benefits across Mini-BESTest, BBS, and TUG. These findings support personalized, balance-focused rehabilitation in PD and highlight the need for clearer intervention protocols.

Identifiers

PMID41876558
PMCPMC13180973

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.