The Role of Physical Activity in Primary and Secondary Prevention in Parkinson’s Disease – A Narrative Review

Introduction: Parkinson's disease (PD) contributes to increasing disability. Among the environmental, lifestyle, dietary, comorbid, and pharmacological factors that have been studied as potentially modifiable protective or risk factors for PD, physical activity (PA) appears to play a significant role in its prevention. Objectives: To present the latest and comprehensive pooled analyses and evidence and to examine their impact on primary and secondary prevention in patients with PD. Methods: A narrative literature review was conducted, searching articles in several databases, including PubMed, the Cochrane Library, Embase, and Web of Science, from 1992 to December 2025. This review focused on leisure-time and lifestyle-related physical activity (PA) and less on structured exercise in PD, which has been previously described in numerous reports. The definition of lifestyle-related physical activity (LAP) developed by Dunn et al. was used, which defines LAP as a daily accumulation of at least 30 minutes of self-selected activity, encompassing all recreational, occupational, or household activities of at least moderate to vigorous intensity, as well as unplanned (less frequently planned) activities that are part of daily life. Results: The most valuable reports on primary and secondary prevention in PD were identified; the latter was less well represented in the literature. Conclusions: Moderate- and vigorous-intensity physical activity plays a protective role in both reducing the risk of PD and slowing the progression of disability in people with PD, particularly in men. Further research is needed to identify specific types of physical activity that will be particularly recommended for patients with Parkinson's disease.