Does Resistance Training Improve the Quality of Life of People With Parkinson's Disease? Evidence and Recommendations for Clinical Application Through a Systematic Review and Meta‐Analysis of Randomized Clinical Trials

BACKGROUND: Parkinson's disease is a neurological condition with motor and non-motor symptoms that negatively affect well-being and quality of life. OBJECTIVE: This review aimed to analyze the effects of resistance training on quality of life in individuals with Parkinson's disease and to summarize recommendations for clinical application. DATA SOURCES: Following PRISMA recommendations, searches were conducted in Web of Science, PubMed, EMBASE (with ClinicalTrials.gov), PEDro, CINAHL, and Scopus. STUDY SELECTION: RCTs were included that compared the effects of resistance training with other therapeutic modalities or a control group on the quality of life in people with Parkinson's. DATA EXTRACTION AND SYNTHESIS: Data were extracted using Microsoft Excel and analyzed in RevMan. The risk of bias was assessed using the RoB 2 tool, the protocol reporting completeness was evaluated using CERT and certainty of the evidence was rated using GRADE. RESULTS: 88%; moderate certainty of the evidence), although no significant difference was found compared to other therapeutic modalities (SMD -0.02; CI -0.44 to 0.41; low certainty of the evidence). Exploratory subgroup analyses suggested a trend toward more favorable results in trials lasting longer than 12 weeks, involving patients with mild-to-moderate disease severity (H&Y ≤ 3), and reporting high protocol completeness (CERT > 11). Most of the studies were classified as having a low risk of bias and presented a moderate description of the protocols in the CERT. LIMITATIONS: The included studies exhibited high heterogeneity and required data imputation for missing standard deviations. Additionally, exploratory subgroup analyses were underpowered due to the limited number of trials. CONCLUSIONS: Current evidence suggests that resistance training may improve quality of life in individuals with Parkinson's disease. Exploratory subgroup analyses tentatively suggest potential trends favoring mild-to-moderate stages and intervention exceeding 12 weeks, while being a safe practice. However, high heterogeneity limits the certainty of the evidence. Future studies should prioritize standardized reporting (CERT) to ensure intervention reproducibility. TRIAL REGISTRATION: PROSPERO record (CRD42024588780).