Ambulatory activity in incident Parkinson’s: more than meets the eye?

Abstract

Physical activity is important for people with Parkinson's disease (PD) to improve disease-specific impairment and ameliorate secondary consequences related to deconditioning. Activity may also have a neuroprotective role if instigated early. Ambulatory activity has not been examined in incident PD. Eighty-nine newly diagnosed PD cases [mean (SD) age 67.3 (9.9) years] and 97 controls [mean (SD) 69.2 (7.7) years] wore an activity monitor (activPAL™) for 7 days. Volume, pattern and variability outcomes were compared. Accumulation of activity (α) was classified as short (< 30 s), medium (30 s-2 min) and long (> 2 min) bouts of walking. Associations between sustained walking (> 2 min) and motor, cognitive and affective characteristics were identified. Activity outcomes were considered with respect to global health recommendations. Total steps (volume), accumulation of bout length (α), and variability (S2w) outcomes were significantly different (all P < 0.001). PD participants (including Hoehn & Yahr (H&Y) stage I) accumulated significantly less time in long bouts (> 2 min) of walking compared with controls, due to performing fewer long bouts, rather than a reduction in time spent in walking per bout. For PD and controls there were weak but significant correlations for a range of characteristics and sustained walking. Fewer people with PD achieved the recommended 30 min of walking per day comprised of bouts> 10 min (P = 0.02) and bouts > 2 min (P < 0.001). People with PD were significantly less active than controls, with an inability to sustain levels of walking, and with differences apparent very early on in the disease process. A focus on increasing general ambulatory activity and exercise from the outset is recommended.

Objective and quantitative assessment of motor function in Parkinson’s disease—from the perspective of practical applications

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Home-Based Physical Behavior in Late Stage Parkinson Disease Dementia: Differences between Cognitive Subtypes

“…Patterns were defined according to (i) total number of bouts per day for each behavior (e.g., number of lying bouts); (ii) mean bout length for each behavior per day (e.g., mean lying bout length), where a bout, similar to other studies [13,25], is defined as any period of time spent in a certain behavior.…”

Effects of Virtual Reality on Parkinsonian Gait: Blind Controlled Randomized Clinical Trial Protocol

“…Parkinson's disease (PD) is a neurodegenerative condition that exerts a negative influence on postural control and mobility, predominantly among older adults, affecting mobility and increasing the risk of slipping, tripping and falls (1) . According to Sanfelice (2) , the diagnosis of PD in the early phases is not easy, but the classic symptoms of tremor, stiffness and bradykinesis can allow the diagnosis on the first evaluation.…”