Natalie E Allen1, Jooeun Song1, Serene S Paul1,2, Catherine Sherrington2, Susan M Murray1, Sandra D O'Rourke1, Stephen R Lord3, Victor S C Fung4,5, Jacqueline C T Close3,6, Kirsten Howard7,8, Colleen G Canning1. 1. Clinical and Rehabilitation Sciences Research Group Faculty of Health Sciences The University of Sydney Sydney Australia. 2. The George Institute for Global Health Sydney Medical School The University of Sydney Sydney Australia. 3. Neuroscience Research Australia UNSW Sydney Australia. 4. Movement Disorder Unit Westmead Hospital Sydney Australia. 5. Sydney Medical School The University of Sydney Sydney Australia. 6. Prince of Wales Clinical School UNSW Sydney Australia. 7. Sydney School of Public Health The University of Sydney Sydney Australia. 8. Institute for Choice University of South Australia Sydney Australia.
Abstract
BACKGROUND: Long-term benefits of exercise for people with Parkinson's disease (PD) require regular and sustained participation. This study aimed to investigate predictors of adherence to a minimally supervised exercise program designed to reduce falls in people with PD. METHOD: People with idiopathic PD who participated in the exercise arm of a randomized, controlled trial were included. Exercises were prescribed three times per week for 6 months. Adherence was defined as the percentage of prescribed sessions participants reported as having undertaken. Potential predictors of adherence included baseline measures of demographic variables, disease severity and duration, falls and fear of falling, pain, self-reported health and quality of life, cognition, physical activity levels, freezing of gait, functional mobility and balance, and knee extensor strength. RESULTS: The 108 participants included undertook a mean of 72% (standard deviation: 38%) of prescribed sessions. Participants had higher levels of adherence if they had shorter disease duration, less bodily pain, and better self-reported health and quality of life. A multivariate model (including disease duration, severity of bodily pain, self-reported physical well-being, the Frontal Assessment Battery, the Short Physical Performance Battery, and maximum walking time) explained 9% of the variance in exercise adherence, with shorter disease duration and less pain the strongest predictors (both predictors standardized β = -0.2; P = 0.04). CONCLUSION: Disease duration and pain are likely to negatively influence exercise participation in people with PD. Given that most of the variance in adherence is unexplained, further work is required to determine other predictors of adherence to long-term exercise programs.
BACKGROUND: Long-term benefits of exercise for people with Parkinson's disease (PD) require regular and sustained participation. This study aimed to investigate predictors of adherence to a minimally supervised exercise program designed to reduce falls in people with PD. METHOD: People with idiopathic PD who participated in the exercise arm of a randomized, controlled trial were included. Exercises were prescribed three times per week for 6 months. Adherence was defined as the percentage of prescribed sessions participants reported as having undertaken. Potential predictors of adherence included baseline measures of demographic variables, disease severity and duration, falls and fear of falling, pain, self-reported health and quality of life, cognition, physical activity levels, freezing of gait, functional mobility and balance, and knee extensor strength. RESULTS: The 108 participants included undertook a mean of 72% (standard deviation: 38%) of prescribed sessions. Participants had higher levels of adherence if they had shorter disease duration, less bodily pain, and better self-reported health and quality of life. A multivariate model (including disease duration, severity of bodily pain, self-reported physical well-being, the Frontal Assessment Battery, the Short Physical Performance Battery, and maximum walking time) explained 9% of the variance in exercise adherence, with shorter disease duration and less pain the strongest predictors (both predictors standardized β = -0.2; P = 0.04). CONCLUSION: Disease duration and pain are likely to negatively influence exercise participation in people with PD. Given that most of the variance in adherence is unexplained, further work is required to determine other predictors of adherence to long-term exercise programs.
Authors: Terry Ellis; James T Cavanaugh; Gammon M Earhart; Matthew P Ford; K Bo Foreman; Lisa Fredman; Jennifer K Boudreau; Leland E Dibble Journal: Phys Ther Date: 2011-10-14
Authors: Claire L Tomlinson; Smitaa Patel; Charmaine Meek; Carl E Clarke; Rebecca Stowe; Laila Shah; Catherine M Sackley; Katherine H O Deane; Clare P Herd; Keith Wheatley; Natalie Ives Journal: Cochrane Database Syst Rev Date: 2012-08-15
Authors: Marlies van Nimwegen; Arlène D Speelman; Sebastiaan Overeem; Bart P van de Warrenburg; Katrijn Smulders; Manon L Dontje; George F Borm; Frank J G Backx; Bastiaan R Bloem; Marten Munneke Journal: BMJ Date: 2013-03-01