Exercise for Gait, Balance and Falls in Parkinson Disease: What Two Network Meta-Analyses Found, and Why They Ranked Exercises Differently

Physical therapists and physical therapist assistants who work with people living with Parkinson disease in outpatient, home health, skilled nursing, neurologic specialty and community wellness settings, and who want a plain-language account of what the current comparative exercise evidence does and does not establish.

Physical therapists and physical therapist assistants. The material is also relevant to occupational therapists and OTAs, athletic trainers and exercise professionals working with neurologic populations. Physical therapist assistants work under the direction and supervision of a physical therapist; evaluation, diagnosis and plan-of-care decisions remain with the supervising therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Mao J, Xia Y, Hu Y, Yao X. The effects of nine types of exercise rehabilitation therapies on improving limb balance, cognitive and emotional function, and quality of life in elderly patients with Parkinson’s disease: a network meta-analysis of 55 RCTs. Front Neurol. 2025;16:1666552. doi:10.3389/fneur.2025.1666552

Tong G, Ouyang J, Xia Y, Cai X. A comparative meta-analysis of seven types of exercise-based physical therapy for gait stabilization, fall risk, and postural control in Parkinson’s disease patients. Front Neurol. 2025;16:1706561. doi:10.3389/fneur.2025.1706561

After completing this course, you will be able to:

1. Describe which exercise categories each of the two network meta-analyses placed at the top of its rankings for balance, cognition, mood, quality of life, gait stabilization, fall risk and postural control, attributing each ranking to the review that reported it.
2. Distinguish the conclusions the two reviews share from the conclusions on which their rankings diverge, including where one review placed an approach near the top and the other placed the same approach near the bottom.
3. Explain the differences in intervention grouping, comparator choice, outcome selection, study pool and reported bias that the two author teams described, and state what each team said about the certainty of its own rankings.

1. Start Here: The Clinical Question and How This Course Is Built
2. Part One: Nine Exercise Categories, Balance, Cognition, Mood and Quality of Life in Parkinson Disease
3. Who Was Studied and Which Nine Exercise Categories Were Compared
4. How the First Review Searched, Pooled and Ranked the Trials
5. What the First Review Reported for Balance, Cognition, Emotional Function and Quality of Life
6. What the First Review's Authors Concluded, and the Limits They Acknowledged
7. Part Two: Seven Exercise-Based Physical Therapy Approaches for Gait Stability, Falls and Postural Control
8. Who Was Studied and How the Seven Approaches Were Defined
9. How the Second Review Built Its Network of Comparisons
10. What the Second Review Reported for Gait Stabilization, Fall Risk and Postural Control
11. Publication Bias, Data Anomalies and the Second Review's Own Cautions
12. Bringing It Together
13. Where the Two Reviews Point the Same Way
14. Where the Rankings Diverge, and Which Review Found What
15. What in the Methods and Outcome Choices Could Account for the Divergence
16. Reading Two Credible Reviews That Disagree: What Is Usable and What Is Still Open
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Mao J, Xia Y, Hu Y, Yao X. The effects of nine types of exercise rehabilitation therapies on improving limb balance, cognitive and emotional function, and quality of life in elderly patients with Parkinson's disease: a network meta-analysis of 55 RCTs. Front Neurol. 2025;16:1666552. doi:10.3389/fneur.2025.1666552
2. Tong G, Ouyang J, Xia Y, Cai X. A comparative meta-analysis of seven types of exercise-based physical therapy for gait stabilization, fall risk, and postural control in Parkinson's disease patients. Front Neurol. 2025;16:1706561. doi:10.3389/fneur.2025.1706561