Determinants of exercise behaviour in persons with Parkinson’s disease

Zaman, Andrew; Ellingson, Laura D.; Sunken, Alyssa; Gibson, Elaine; Stegemöller, Elizabeth L.

doi:10.1080/09638288.2019.1638975

Cited by 29 publications

(20 citation statements)

References 26 publications

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“…Attendance rates to on-site training sessions varied between 87 and 100% [25,26,28,30,32,36], and adherence to exercise frequency in partly or unsupervised settings was still good (> 75% sessions attended) [4,23,33]. Although adherence is overall good in clinical trials, in daily life, many practical barriers must be overcome [57][58][59][60][61][62][63][64]. Barriers include a range of factors like low self-efficacy, generic health issues, poor access to the exercise location, mobility problems such as postural instability, and non-motor symptoms such as fatigue and depression [57][58][59][60][61][62][63][65][66][67][68][69][70][71].…”

Section: Adherencementioning

confidence: 99%

“…Although adherence is overall good in clinical trials, in daily life, many practical barriers must be overcome [57][58][59][60][61][62][63][64]. Barriers include a range of factors like low self-efficacy, generic health issues, poor access to the exercise location, mobility problems such as postural instability, and non-motor symptoms such as fatigue and depression [57][58][59][60][61][62][63][65][66][67][68][69][70][71]. On the other hand, social support by family, friends, or a professional and education about the benefits of exercise can motivate PD patients to become more physically active [57,59,60,[62][63][64][65][66][67][68][69][72][73][74].…”

Section: Adherencementioning

confidence: 99%

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Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

et al. 2020

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Parkinson’s disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body’s large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VO2max), motor symptoms (Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson’s disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VO2max) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life.

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Section: Adherencementioning

confidence: 99%

Section: Adherencementioning

confidence: 99%

Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

et al. 2020

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“…First, factors in the category of body structure and function can be related to general health issues [10,15,[17][18][19][20]. Barriers related to motor symptoms and common non-motor symptoms of PD, such as depression and apathy, which are often not considered when studying exercise adherence, can have a major impact and should be addressed carefully [15][16][17][18][20][21][22][23][24][25]. Second, although only few factors related to activities and participation were identified, assessing a person's (in)ability to integrate exercise into daily life routines is key [10,11,25,26].…”

Section: Search Strategy and Classification Of Barriers And Motivatorsmentioning

confidence: 99%

“…Sufficient self-efficacy plays a pivotal role in the likelihood that persons Table 1 Barriers to start with exercise or to remain engaged in exercise, as these have been described for persons with PD. References are grouped according to the type of study (randomized clinical trial -RCT, cohort study, qualitative study or review) Bad weather [17,20] [25] Cultural challenges [16] Financial burden of exercise [16] Wariness of moving in a crowded environment [25] with PD will start engaging in exercise and remain engaged [11,16,19,[22][23][24]26]. Also, it is well known that having low outcome expectations can be a major barrier to initiate exercise [11,16,17].…”

Section: Search Strategy and Classification Of Barriers And Motivatorsmentioning

confidence: 99%

Barriers and Motivators to Engage in Exercise for Persons with Parkinson’s Disease

Schootemeijer

Kolk

Ellis

et al. 2020

JPD

105

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Exercise is increasingly being recognized as a key element in the overall management of persons living with Parkinson’s disease (PD) but various (disease-specific) barriers may impede even motivated patients to participate in regular exercise. We aimed to provide a comprehensive review of the various barriers and motivators for exercise in persons with PD. We scrutinized data on compliance-related factors published in cross-sectional studies, randomized controlled trials and reviews. We classified the barriers and motivators to exercise from a patient perspective according to the International Classification of Functioning, Disability and Health. We present an overview of the large range of potential motivators and barriers for exercise in persons with PD. Healthcare professionals should consider a wide and comprehensive range of factors, in order to identify which specific determinants matter most for each individual. Only when persons with PD are adequately motivated in a way that appeals to them and after all person-specific barriers have been tackled, we can begin to expect their long-term adherence to exercise. Such long-term compliance will be essential if exercise is to live up to its expectations, including the hope that prolonged engagement in regular exercise might help to modify the otherwise relentlessly progressive course of PD.

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“…Previous studies suggest that individuals with PD should interact with physical intervention activities as an adjunct intervention to pharmacological therapies [4,12]. Structured intervention programs also include natural and beneficial aspects of social engagement that group exercise programs can provide [15,16]. Recent social engagements for individuals with PD are also associated with better global cognition, whereas low levels of social engagement were associated with an increased risk of dementia [17].…”

Section: Interventionsmentioning

confidence: 99%

Negative Effects of COVID-19 Stay-at-Home Mandates on Physical Intervention Outcomes: A Preliminary Study

Templeton

Poellabauer

Schneider

2021

JPD

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Background: Due to the COVID-19 pandemic, beneficial physical intervention classes for individuals with Parkinson’s disease (PD) were cancelled. Objective: To understand effects of the COVID-19 stay-at-home mandate and the inability to participate in recommended and structured physical interventions as a consequence of these mandates, specifically designed mobile assessments were used that collected both self-reporting information and objective task-based metrics of neurocognitive functions to assess symptom changes for individuals with PD. Methods: Self-reporting questionnaires focusing on overall quality of life (e.g., when individuals typically feel at their best, changes in activity levels, and symptom progression) were given to all individuals (n = 28). In addition, mobile-based neurocognitive assessments were administered to a subset of the population (n = 8) to quantitatively assess changes due to COVID-19 restrictions. Results: The highest self-reported factors in which individuals denoted feeling their best were after exercise (67.86%) and being in a comfortable and supportive environment (60.71%). Objective measures found overall duration of physical activity during the stay-at-home mandate decreased significantly (p = 0.022). With the lack of overall activity, 82.14%of individuals self-reported having at least one symptom that worsened moderately or higher. Further testing, using mobile-based assessments, showed average completion times of functional tasks increased, taking about 2.1 times longer, while accuracy metrics showed overall degradation. Conclusion: Although the COVID-19 stay-at-home mandate was intended to help protect individuals at high risk from coming into contact with the virus, it also prevented individuals from receiving recommended supervised exercise interventions resulting in significant negative effects in social well-being and across motor and speech neurocognitive tasks for individuals with PD.

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Determinants of exercise behaviour in persons with Parkinson’s disease

Cited by 29 publications

References 26 publications

Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

Current Perspectives on Aerobic Exercise in People with Parkinson's Disease

Barriers and Motivators to Engage in Exercise for Persons with Parkinson’s Disease

Negative Effects of COVID-19 Stay-at-Home Mandates on Physical Intervention Outcomes: A Preliminary Study

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