Exergaming Compared to Conventional Physical Exercise Interventions on Health Status in Older People with Parkinson's Disease: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.

Background and Objectives: This systematic review aimed to analyze published peer-reviewed studies on the effects of exergaming (EXG) compared to conventional physical exercise (CPE) interventions on health status in older people with Parkinson's disease (PD) according to training dose. Materials and Methods: Using six generic databases: PubMed, EBSCO, Medline, CINAHL Complete, Scopus, and Web of Science, the PRISMA, TESTEX, RoB 2, and GRADE tools assessed methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024575969). Results: Out of 805 records, 14 randomized controlled trials with 406 older people with PD were included. Seven overall meta-analyses showed significant improvements (p < 0.01) in favor of EXG in the Berg Balance Scale (BBS, ES = 0.90), Dynamic Gait Index (DGI, ES = 0.77) and quality of life questionnaire (PDQ-39, ES = 0.52), without significant improvements (p > 0.05) in the Unified PD Rating Scale, Montreal Cognitive Assessment, Timed Up-and-Go and Falls Efficacy Scale-International. Four subgroup meta-analyses, according to training schedules, showed that there were significant improvements (p < 0.05) in BBS in favor of EXG at >8 weeks of training (ES = 1.38), >3 weeks per week (ES = 1.18), <45 min duration (ES = 0.99), and with >20 total sessions (ES = 1.31). Both weeks and total sessions were predictors of BBS performance in EXG interventions in older people with PD. Conclusions: EXG is an innovative alternative to improve the health status in balance, gait, and quality of life variables in older people with PD, with a high potential for clinical practice in this population. The training dose is a determinant (weeks and total sessions) that varies the response to intervention in the BBS.