Dijital Sağlık Müdahalelerinin Parkinson Hastalığı Olan Hastalarda Motor Semptomları, Motor Olmayan Semptomlar ve Yaşam Kalitesi Üzerindeki Etkileri: Randomize Kontrollü Denemelerin Sistematik İncelemesi ve Meta-Analizi.

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BackgroundParkinson disease (PD) is a progressive neurodegenerative disorder with increasing global prevalence, necessitating innovative management. Digital health interventions (DHIs) offer potential advantages for PD care; yet, a comprehensive systematic review and synthesis across all DHI types and core outcomes is still lacking.ObjectiveThis review aimed to assess the effectiveness of DHIs for improving motor symptoms, nonmotor symptoms, and quality of life in patients with PD and to summarize the reach, uptake, and feasibility.MethodsWe searched PubMed, Ovid Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, and APA PsycINFO up to November 2025. Pooled standardized mean differences (SMDs) were calculated using random-effects models. We calculated 95% prediction intervals (PIs) to estimate the true effects. The revised Cochrane Risk of Bias 2 tool was used to assess risk of bias. Heterogeneity was assessed using I2, τ2, and 95% PI. Subgroup analyses, meta-regression, and sensitivity analyses were conducted to address heterogeneity and potential bias. The quality of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development, and Evaluation).ResultsThe review included 112 randomized controlled trials involving 5594 participants. Significant postintervention improvements were identified in motor symptoms (SMD=-0.39, 95% CI -0.60 to -0.18, 95% PI -1.75 to 0.99; I2=80.3%) and overall nonmotor symptoms (SMD=-0.26, 95% CI -0.49 to -0.03, 95% PI -0.56 to 0.03; I2=13.8%), including cognitive function (SMD=0.47, 95% CI 0.22 to 0.72, 95% PI -0.41 to 1.35; I2=63.5%) and psychiatric symptoms (SMD=-0.42, 95% CI -0.74 to -0.09, 95% PI -1.82 to -0.99; I2=85.4%); however, there was no significant enhancement in quality of life (SMD=-0.19, 95% CI -0.47 to 0.09, 95% PI -1.50 to 1.12; I2=81.2%). The certainty of evidence was very low for quality of life, motor, and psychiatric symptoms and low for cognitive function and overall nonmotor symptoms. Improvements in motor symptoms and cognitive function remained stable at follow-up. Meta-regression analysis indicated that age, percentage of female participants, and supervision mode were possible sources of heterogeneity. Overall, 94 studies reported reach (median 37.5%), 38 reported fidelity (95.7%), and 105 reported dropout rates (9.1%).ConclusionsIn contrast to previous reviews focused on single technologies or outcomes, this review provided the first comprehensive synthesis across all DHI types on multiple outcomes and indicated their potential as nonpharmacological interventions for PD management. However, current evidence is of low to very low certainty, and wide 95% PIs, together with high risk of bias and substantial heterogeneity, indicate considerable uncertainty regarding the true effect in future implementations. Therefore, findings should be interpreted with caution. These findings provide integrated evidence to guide the design and prioritization of future research. The results have important real-world implications, supporting cautious implementation while underscoring the need for more robust trials, particularly in resource-limited settings.Trial registrationPROSPERO CRD42023492123; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023492123.

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