Comparative effects of medication combined with twenty rehabilitation therapies: core outcomes in 8202 parkinson’s patients

Parkinson's disease (PD) is a neurodegenerative disorder with complex motor and non-motor symptoms. This network meta-analysis evaluated the combined effects of medication and 20 rehabilitation therapies on motor function, neuro-psychiatric health, and quality of life in 8202 PD patients across 186 randomized controlled trials. Traditional Chinese Rehabilitation Therapy (TCRT), Exoskeleton-Assisted Rehabilitation Therapy (EART), Hydrotherapy Rehabilitation Therapy (HRT), and Conventional Kinesitherapy (CKT) significantly improved balance, while Mind-Body Exercise Therapy (MBET) and Non-Invasive Brain Stimulation Therapy (NIBST) enhanced overall motor capacity and reduced freezing of gait (FOG). Resistance Training Rehabilitation Therapy (RTRT) and Non-Invasive Brain Stimulation Therapy (NIBST) improved cognitive function, and Mind-Body Exercise Therapy (MBET) alleviated negative mood. Upper Limb Rehabilitation Therapy (ULRT) and Resistance Training Rehabilitation Therapy (RTRT) showed notable quality-of-life benefits. However, confidence in outcomes was often low due to risk of bias and imprecision. Meta-regression indicated that intervention duration was negatively correlated with cognitive gains. These findings highlight the need for precise, integrated rehabilitation strategies targeting specific symptoms to optimize PD management. Future research should explore individualized, mechanism-driven approaches to advance precision rehabilitation.