The effects of aerobic exercise on quality of life and motor function in patients with Parkinson’s disease: a systematic review and meta-analysis

To systematically evaluate the effects of aerobic exercise on motor function and quality of life in patients with Parkinson’s disease, to provide evidence-based guidance for individualized exercise prescription. PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to October 2025 for randomized controlled trials of ≥ 4 week aerobic exercise programmes (treadmill training, Nordic walking, aerobic exercise, cycling, walking, dance, Qigong) in adults with Parkinson’s disease. Primary outcomes were the Unified Parkinson’s Disease Rating Scale Part III (UPDRS-III), Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), and the 39-item Parkinson’s Disease Questionnaire (PDQ-39). Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random-effects meta-analysis, with sensitivity analyses and funnel plots used to assess robustness and publication bias. A total of 27 articles comprising 918 participants were included. Aerobic exercise significantly improved UPDRS-III (SMD = − 0.75, I² = 71%), TUG (SMD = − 0.82, I² = 44%), 6MWT (SMD = 0.82, I² = 80%), and BBS (SMD = 1.15, I² = 28%). Mini-BESTest also improved (SMD = 0.61, I² = 78%). PDQ-39 showed a non-significant trend toward improvement (SMD = − 0.17, I² = 0%). Sensitivity analyses supported the primary findings, and funnel plots did not suggest substantial publication bias. Aerobic exercise produces moderate-to-large improvements in motor function, balance, and walking endurance, while exerting only small, non-significant effects on health-related quality of life in people with Parkinson’s disease. These findings support the integration of regular aerobic training as a core component of comprehensive PD management and provide quantitative benchmarks for prescribing exercise in clinical practice.