Analysis of 24-h Physical Activities of Patients with Parkinson's Disease at Home

Abstract

Abstract.[Purpose] The present study aimed to quantitatively evaluate and characterize the physical activities of people with Parkinson's disease (PD) receiving nursing care at home, as well as to clarify the factors that affect the amount of physical activity and the ability of people with PD to perform activities.[Subjects] Nine PD patients participated in this study.[Methods] The physical activities of subjects were measured over a 24-h period using an accelerometer and an activity meter simultaneously.[Results] The average total impulse value of PD patients was approximately equal to that of elderly people, and was lower than that of young adults reported in other studies. Over the 24-h study period, PD patients spent 43.6% of the time in a sitting position. Patients with milder PD were more physically active, had higher activities of daily living, had better balance ability in a standing position, were able to stand for longer periods, and showed more frequent posture changes; however, their frequency of falls tended to increase. [Conclusion] To increase physical activities and prevent falls among home-bound PD patients, it is important to practice standing balance and walking exercises.

Systematic Review Looking at the Use of Technology to Measure Free-Living Symptom and Activity Outcomes in Parkinson’s Disease in the Home or a Home-like Environment

“…Of the studies included in the review, 17 measured the metric of physical activity. 13 of these papers described the use of single wearable devices [29,36,41,46,49,67,[70][71][72][73][74][75][76], whereas four used multiple wearables [35,50,77,78]. Each study used accelerometry only to measure physical activity except for Cereda et al, who used accelerometry, body temperature, skin conductivity and the sleep-wake rhythm to measure total daily energy expenditures, physical activity, number of steps and metabolic rate of their participants [74] in the context of investigating the impact of a low protein diet on physical activity and energy expenditure.…”

“…Accuracy of the technology was evaluated by Silva de Lima et al [46], Skidmore et al [70] and Wallen et al [72] with > 95% accuracy found in the former two studies. Agreement with a number of different tools (including UPDRS II & III, Functional Independence Scale, Functional Balance Measure) was investigated by 5 papers [29,36,49,70,78] with varying results. These included the absence of agreement being noted, for example between accelerometry measuring physical activity and the UPDRS motor subscale (III) [29,49].…”

Auditing the Physical Activity and Parkinson Disease Literature Using the Behavioral Epidemiologic Framework

“…In phase 2, there were 18 articles that examined methods used to quantify physical activity and to evaluate outcomes in the literature. The majority focused on the use of objective measures, including step activity monitors [150‐155] and accelerometers [156‐159]. Three articles studied the use of self‐report measures compared with activity monitors and proxy reports as well as looking at the reliability of specific measures [160‐162].…”

“…As anticipated, phase 2 had the second most number of articles, although it should be noted that there were only 18 articles (just more than 10% of the total), which represents a significantly lower number compared with phase 1. Given the predominance of studies demonstrating the effectiveness of using accelerometers as an outcome measure for individuals with PD [150‐159], it is surprising how few studies in subsequent phases incorporated accelerometers to quantify physical activity. In particular, inclusion of accelerometers as a primary outcome in phase 4 projects would allow for robust quantitative assessment of the effectiveness of behavioral interventions.…”

Effects of Home Exercise on Physical Function and Activity in Home Care Patients with Parkinson’s Disease

“…The decreased time spent lying down is particularly suggestive of the effectiveness of the intervention in improving physical activity status. Because PD patients have reduced opportunities for walking owing to their increased risk of falling 39 ) , these patients are prone to sedentary living 40 ) , and their decreased activity can contribute to disuse syndrome 40 ) . Furthermore, because many patients with PD experience difficulty in rolling over with progression of the disease 29 ) , bed rest in a supine position tends to be prolonged.…”