Effects of Physical Exercise on Fall Risk in Patients With Parkinson’s Disease and Other Forms of Parkinsonism: An Overview of Systematic Reviews

Abstract

Falls are among the most important causes of preventable morbidity in older adults worldwide. The objective of this review is to evaluate whether exercise-based interventions, compared with non-exercise or other physical activity interventions, reduce fall risk in community-dwelling patients with Parkinson’s disease (PD). A systematic search of PubMed/MEDLINE, Europe PMC, and Directory of Open Access Journals identified relevant articles published from 2020 to October 3, 2025. We included free full-text systematic reviews that examined more than one type of exercise modality, assessed predefined risk factors for falls, and included community-dwelling participants. Ten systematic reviews met the inclusion criteria. Physical exercise significantly improved motor function, gait, balance, and postural stability in PD, with robust statistical evidence supporting its effectiveness. Meta-analyses involving more than 7,000 patients showed that exercise reduced Unified Parkinson’s Disease Rating Scale part III motor scores, with aerobic training providing the greatest benefit. Combined aerobic and resistance training yielded synergistic effects on functional mobility (standardized mean difference = 0.74, 95% confidence interval: 0.49–1.00). Tai chi improved balance scores (mean difference = 3.56; P < 0.00001), while dance markedly enhanced gait velocity (standardized mean difference = 2.11; 95% confidence interval: 1.07–3.15). Overall, the evidence supports continuous, moderate-to-high intensity exercise—tailored to patients’ needs and tolerance—as a safe, effective strategy to improve motor outcomes and reduce fall risk in PD.