To assess the effect of different exercise intensities in individuals with Parkinson’s disease.

Following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, we conducted a systematic literature search across 4 databases (PubMed, Web of Science, Scopus and Scholar) from inception till May 2025, the Cochrane risk of bias 2 tool was used for assessment of the quality of the included studies. Statistical analysis was performed using RevMan web software, random effect model has been utilized. Dichotomous outcomes were subjected to risk ratio analysis (RR), while continuous outcomes were pooled using mean difference (MD), all were reported with 95% confidence interval (CI).

Fourteen studies met inclusion criteria, of which 11 were included in the quantitative synthesis. High-intensity exercise significantly demonstrated improvement in motor function (UPDRS III MD –3.38; 95% CI –5.88 to –0.88; P = 0.008; I² = 2%), aerobic capacity (VO2 max MD 2.27 mL·kg?¹·min?¹; 95% CI 1.24 to 3.29; P < 0.0001; I² = 49%), and quality of life (PDQ-39 MD –0.61; 95% CI –0.95 to –0.28; P = 0.0004; I² = 0%). No significant differences were noticed for activities of daily living (UPDRS II), overall disease severity (UPDRS total), or 6-minute walk distance. In direct comparison, high-intensity exercise demonstrated a non-significant increase in VO2 max compared to low-to-moderate intensity.

High-intensity exercise significantly improves motor function, aerobic capacity, and quality of life in Parkinson’s disease, supporting its integration into rehabilitation programs while underscoring the need for larger trials to evaluate nonmotor and functional outcomes.