Recent advances in rehabilitation for Parkinson's Disease with Exergames: A Systematic Review.
Augusto Garcia-Agundez, Ann-Kristin Folkerts, Robert Konrad and 5 others
PMID 30696453WHAT IT FOUND
Exercise video games, often paired with balance training or usual exercise, were safe and feasible.
Several groups improved balance, gait or alertness at least as much as usual therapy, but no single game or platform clearly worked best.
Key findings
01The review identified 9 randomized controlled trials and 11 pilot studies of exergames for Parkinson's disease.
02In several randomized trials, the exergame group also received balance training, stretching, strengthening or treadmill exercise, so the review cannot attribute any benefit to the game alone.
03Across the randomized trials, exergame groups performed equal to or better than active control groups doing traditional rehabilitation or regular exercise, but the review could not determine which therapy works best.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trials did not use standardized outcomes, follow-up protocols or patient assessment methods, so it is hard to compare which game or sensor works best. 7 randomized trials were single-blinded, which leaves room for selection bias. Only the Tollar trial mentioned effect sizes, so the size of benefit is unclear. Pilot studies had low sample sizes and insufficient intervention durations, so some outcome changes were not statistically significant. All randomized trials excluded people with MMSE scores below 24, so the evidence does not cover Parkinson's dementia or mild cognitive impairment. Home and unsupervised scenarios are mentioned, but safety and adherence remain largely unaddressed. The review could not perform a broad meta-analysis of platforms because only a few trials reported comparable outcomes.
Declared interests
The review was funded by the German Ministry of Research and Education (BMBF). It also states that none of the identified randomized controlled trials reported any conflict of interest.
The easy way to misread this
Do not read this review as proof that exergames alone improve Parkinson's symptoms. Many trials combined exergames with balance training, stretching, strengthening or treadmill exercise, so the contribution of any single component cannot be separated.