Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease

Quinn, Lori; Busse, Monica; Khalil, Hanan; Richardson, Sue; Rosser, Anne Elizabeth; Morris, Huw R.

doi:10.3109/09638280903362712

Cited by 80 publications

(73 citation statements)

References 48 publications

(56 reference statements)

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“…62 Other studies of people with PD have suggested that a patient-centered approach, in which therapists work in partnership with people to facilitate a better understanding of the goals and outcomes expected from exercise, also may help to increase self-efficacy. 31,63 The results of the present study may have been influenced by differences in the characteristics of the exercise and nonexercise groups. For example, the nonexercise group had a longer duration of PD; however, disease severity, as measured by H&Y stage, did not differ between the exercise group and the nonexercise group.…”

Section: Barriers To Exercise In People With Parkinson Diseasementioning

confidence: 72%

“…30 A lack of a patientcentered approach to prescribing exercise may further limit motivation and outcome expectations. 31 The purpose of the present study was to identify barriers to exercise in people who have PD and dwell in the community. All evaluators were provided with a standard operating procedures manual and an instructional video that described the protocol for administering and scoring each instrument for 2 participants with PD.…”

Section: Barriers To Exercise In People With Parkinson Diseasementioning

confidence: 99%

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Barriers to Exercise in People With Parkinson Disease

Boudreau²,

et al. 2013

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BackgroundExercise is known to reduce disability and improve quality of life in people with Parkinson disease (PD). Although barriers to exercise have been studied in older adults, barriers in people with chronic progressive neurological diseases, such as PD, are not well defined.ObjectiveThe purpose of this study was to identify perceived barriers to exercise in people with PD.DesignThe study had a cross-sectional design.MethodsPeople who had PD, dwelled in the community, and were at stage 2.4 on the Hoehn and Yahr scale participated in this cross-sectional study (N=260; mean age=67.7 years). Participants were divided into an exercise group (n=164) and a nonexercise group (n=96). Participants self-administered the barriers subscale of the Physical Fitness and Exercise Activity Levels of Older Adults Scale, endorsing or denying specific barriers to exercise participation. Multivariate logistic regression analysis was used to examine the contribution of each barrier to exercise behavior, and odds ratios were reported.ResultsThree barriers were retained in the multivariate regression model. The nonexercise group had significantly greater odds of endorsing low outcome expectation (ie, the participants did not expect to derive benefit from exercise) (odds ratio [OR]=3.93, 95% confidence interval [CI]=2.08–7.42), lack of time (OR=3.36, 95% CI=1.55–7.29), and fear of falling (OR=2.35, 95% CI=1.17–4.71) than the exercise group.LimitationsThe cross-sectional nature of this study limited the ability to make causal inferences.ConclusionsLow outcome expectation from exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise in people who have PD, are ambulatory, and dwell in the community. These may be important issues for physical therapists to target in people who have PD and do not exercise regularly. The efficacy of intervention strategies to facilitate exercise adherence in people with PD requires further investigation.

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Section: Barriers To Exercise In People With Parkinson Diseasementioning

confidence: 72%

Section: Barriers To Exercise In People With Parkinson Diseasementioning

confidence: 99%

Barriers to Exercise in People With Parkinson Disease

Boudreau²,

et al. 2013

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“…Including an unsupervised home programme as part of an intervention reduces the burden on resource limited physiotherapy services, promotes autonomy and enables patients to increase their physical activity levels. A range of opportunities to participate in exercise interventions, such as groups or individually delivered sessions, should be available in practice in order to meet the needs of differing patient circumstances and motivations 27 28…”

Section: Discussionmentioning

confidence: 99%

An exercise intervention to prevent falls in people with Parkinson's disease: a pragmatic randomised controlled trial

Goodwin

Richards

Henley

et al. 2011

Journal of Neurology, Neurosurgery & Psychiatry

141

167

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Objectives To compare the effectiveness of an exercise programme with usual care in people with Parkinson's disease (PD) who have a history of falls. Design Pragmatic randomised controlled trial. Setting Recruitment was from three primary and four secondary care organisations, and PD support groups in South West England. The intervention was delivered in community settings. Participants People with PD, with a history of two or more falls in the previous year, who were able to mobilise independently. Intervention 10 week, physiotherapy led, group delivered strength and balance training programme with supplementary home exercises (intervention) or usual care (control). Main outcome measure Number of falls during the (a) 10 week intervention period and (b) the 10 week followup period. Results 130 people were recruited and randomised (64 to the intervention; 66 to usual care). Seven participants (5.4%) did not complete the study. The incidence rate ratio for falls was 0.68 (95% CI 0.43 to 1.07, p¼0.10) during the intervention period and 0.74 (95% CI 0.41 to 1.33, p¼0.31) during the follow-up period. Statistically significant between group differences were observed in Berg balance, Falls Efficacy Scale-International scores and recreational physical activity levels. Conclusions The study did not demonstrate a statistically significant between group difference in falls although the difference could be considered clinically significant. However, a type 2 error cannot be ruled out. The findings from this trial add to the evidence base for physiotherapy and exercise in the management of people with PD. Trial registration ISRCTN50793425.

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“…These findings are reflected in the recent review by York and Wiseman (2012) and by the results in this study. The desirability of physical exercise and leisure for HD clients is mentioned in studies by Quinn et al (2010) and McCabe, Roberts, and Firth (2008) but gardening is not mentioned as a possible activity in either paper.…”

Section: Discussionmentioning

confidence: 94%

Is gardening a stimulating activity for people with advanced Huntington's disease?

et al. 2013

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This study evaluated adapted gardening as an activity for people with advanced Huntington's disease (HD) and explored its therapeutic aspects. Visitors and staff completed a questionnaire and participated in structured interviews to capture further information, whereas a pictorial questionnaire was designed for residents with communication difficulties. Staff reported that gardening was a constructive, outdoor activity that promoted social interaction, physical activity including functional movement and posed cognitive challenges. Half the staff thought the activity was problem free and a third used the garden for therapy. Visitors used the garden to meet with residents socially. Despite their disabilities, HD clients enjoyed growing flourishing flowers and vegetables, labelling plants, being outside in the sun and the quiet of the garden. The garden is valued by all three groups. The study demonstrates the adapted method of gardening is a stimulating and enjoyable activity for people with advanced HD.

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Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease

Abstract: Therapists should work in collaboration with clients to evaluate their individual considerations, identify barriers to exercise and design a client-specific programme that is acceptable and feasible for the client.

Cited by 80 publications

References 48 publications

Barriers to Exercise in People With Parkinson Disease

Barriers to Exercise in People With Parkinson Disease

An exercise intervention to prevent falls in people with Parkinson's disease: a pragmatic randomised controlled trial

Is gardening a stimulating activity for people with advanced Huntington's disease?

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