Regular Exercise, Quality of Life, and Mobility in Parkinson’s Disease: A Longitudinal Analysis of National Parkinson Foundation Quality Improvement Initiative Data

Abstract

Background Research-based exercise interventions improve health-related quality of life (HRQL) and mobility in people with Parkinson’s disease (PD). Objective To examine whether exercise habits were associated with changes in HRQL and mobility over two years. Methods We identified a cohort of National Parkinson Foundation Quality Improvement Initiative (NPF-QII) participants with three visits. HRQL and mobility were measured with the Parkinson’s Disease Questionnaire (PDQ-39) and Timed Up and Go (TUG). We compared self-reported regular exercisers (≥2.5 hours/week) with people who did not exercise 2.5 hours/week. Then we quantified changes in HRQL and mobility associated with 30-minute increases in exercise, across PD severity, using mixed effects regression models. Results Participants with three observational study visits (n = 3408) were younger, with milder PD, than participants with fewer visits. After 2 years, consistent exercisers and people who started to exercise regularly after their baseline visit had smaller declines in HRQL and mobility than non-exercisers (p < 0.05). Non-exercisers worsened by 1.37 points on the PDQ-39 and a 0.47 seconds on the TUG per year. Increasing exercise by 30 minutes/week was associated with slower declines in HRQL (−0.16 points) and mobility (−0.04 sec). The benefit of exercise on HRQL was greater in advanced PD (−0.41 points) than mild PD (−0.14 points; p < 0.02). Conclusions Consistently exercising and starting regular exercise after baseline were associated with small but significant positive effects on HRQL and mobility changes over two years. The greater association of exercise with HRQL in advanced PD supports improving encouragement and facilitation of exercise in advanced PD.

Functional outcomes of an integrated Parkinson's Disease Wellbeing Program

“…A small study of 51 mild‐to‐moderate non‐demented PD patients randomised to either progressive resistance training or Modified Fitness Counts reported that both treatment modalities improved attention and working memory . The National Parkinson Foundation QII registry study also found that patients with PD who regularly exercised >150 min/wk had less cognitive decline at 12‐month follow‐up . Further research into the long‐term cognitive benefits of exercise therapy in PD is warranted.…”

“…19 The National Parkinson Foundation QII registry study also found that patients with PD who regularly exercised >150 min/wk had less cognitive decline at 12-month follow-up. 2 Further research into the long-term cognitive benefits of exercise therapy in PD is warranted.…”

“…Animal models of PD suggest physical activity may have a neuroprotective or neurorestorative effect . There is growing evidence that regular physical activity is associated with greater QoL, physical function and lower caregiver burden . Physical therapy studies in patients with PD have assessed different aspects of upper and lower limb function, including balance and gait, physical activity and cognition, and their effect on patient independence, safety and sense of well‐being …”

Parkinson’s Disease in Women and Men: What’s the Difference?

“…Physical activity is another important lifestyle factor that may affect PD onset, severity and progression. High levels of exercise in midlife are associated with lower PD risk, better disease prognosis and lower rates of serious complications [61]. A large international multicenter cohort study on early PD patients showed that higher self-reported activity scores were associated with younger age and male gender.…”

Environment, lifestyle, and Parkinson's disease: Implications for prevention in the next decade

“…At the other end of the disease spectrum, regular physical activity seems to particularly enhance quality of life in those with advanced disease, therefore studies testing exercise/physical activity interventions targeting this population are urgently required. As well as investigating high‐intensity exercise, trials aiming to increase routine daily physical activity and reduce sedentary behavior are on the horizon and may be more acceptable to some people with PD.…”