The Significance of Walking from the Perspective of People with Parkinson's Disease

Abstract

Background: Parkinson's disease (PD) is associated with progressive mobility and walking difficulties. Although these aspects have been found to be central from a patient perspective, the perceived significance of walking is less well understood. Objective: To explore the significance of walking as perceived and experienced by individuals with PD. Methods: Eleven persons with PD (seven men; median age, 71 years; median PD duration, 7 years) participated. Data were collected through semi-structured interviews, which were recorded and transcribed verbatim. Data were qualitatively analysed by systematic text condensation. Results:The ability to walk had a complex and multifaceted impact on the participants, including physical, psychological and emotional aspects as well as on the ability to be active in daily life and to participate in society. The central role of coping strategies was prominent in filtering emotional reactions to physical changes, and when managing the activities and participation in everyday situations. The sense of unpredictability, uncertainty and loss of control were underlying phenomena in all categories. Furthermore, inability to manage walking difficulties had a negative impact on the participants' self-concept. Conclusions: The central meaning of being able to walk appears to be intimately linked to an individual's social identity, emotional well-being and integrity. Consequently, being able to walk independently was a prerequisite to an autonomous life and participation in society. This implies that rehabilitation and other mobility interventions also need to consider individual emotional, psychological, and social implications, and to facilitate appropriate compensatory and coping strategies.

Subjective and psychological well-being in Parkinson's Disease: A systematic review

“…[27][28][29][30][31] The articles in the present review suggested that certain dimensions such as life engagement, purpose in life, self-acceptance, environmental mastery, and personal growth are associated with less disability (both motor and non-motor symptoms) in PD. [44][45][46][47] Thus, it appears that the protective role of PWB in adjusting to PD is confirmed, but it still needs further investigations, with standardized psychometric tools. Studies included in this review assessed PWB mainly with open-ended interviews.…”

“…The remaining studies mainly considered only psychological indicators, such as depression, anxiety, coping strategies, or other indicators of quality of life. 38,40,41,[43][44][45]47 Bearing all these limitations in mind, an important common finding that emerged from the review of these articles concerns the preservation of motor skills. It is fundamental for maintaining LS, well-being, and favoring social contribution of patients with PD.…”

“…This participation maintains a sense of self-efficacy and environmental mastery. 44,45 Moreover, tango interventions and other innovative rehabilitation programs, which involve music, singing, and other leisure activities, appear to be effective in improving well-being, as well as motor and non-motor symptoms. Thus, these innovations could be included in standard rehabilitation programs for PD.…”

“…Psychological well-being has been investigated in 4 studies: 2 qualitative and cross-sectional, 44,45 one quantitative and cross-sectional, 46 and another quantitative and longitudinal. 47 In the qualitative ones, patients with PD were interviewed to better capture the features of their living conditions.…”

“…In turn, these dimensions may favor the adaptation to the illness itself. [36][37][38][39][40][41][42][43][44][45][46][47] Furthermore, patients with PD may show some deficits in recognizing emotions, compared to healthy controls. 48,49 In addition, depression and apathy are considered core symptoms of PD and they were found to be related to dopamine depletion or to a negative emotional consequence of disability and activity restriction.…”