Do Leg-Focused Exercises Improve Arm and Hand Function for Individuals With Neurologic Disorders? A Scoping Review.

Objective: To perform a scoping review summarizing existing literature on the use of leg exercises to improve arm function for individuals living with neurologic conditions. Data Sources: We searched 5 databases (PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus, Cochrane Central), secondary references, and 9 gray literature databases from January 1, 1947, to October 28, 2025. Study Selection: Studies were included if they involved adults living with neurologic conditions conducting leg-focused exercise programs that included an arm-specific outcome. All were written in English. Two reviewers independently screened all articles. Data Extraction: Data were extracted by one reviewer and confirmed by a second. Methodological quality was assessed using Physiotherapy Evidence Database scale. Data Synthesis: A total of 12 published studies met criteria. Studies involved 6-101 participants living with deficits because of stroke or Parkinsons disease. Participants performed leg-focused exercises, ranging from a single session up to 100 sessions, followed by upper extremity assessments. Of the 12 studies, 6 showed a statistically significant or clinically relevant benefit of leg exercise on arm function. However, these were mostly observed as incidental findings. Conclusions: This scoping review highlights a gap in research on the use of leg training to activate arm motor circuits for individuals living with neurologic conditions. Future research should explore this approach as a novel method for neurorehabilitation.