Exploring factors related to physical activity in cervical dystonia

Abstract

BackgroundPeople with disabilities have reported worse health status than people without disabilities and receiving fewer preventive health services such as counseling around exercise habits. This is noteworthy considering the negative consequences associated with physical inactivity. No research has been conducted on physical activity in cervical dystonia (CD), despite its possible major impact on self-perceived health and disability. Considering the favorable consequences associated with physical activity it is important to know how to promote physical activity behavior in CD. Knowledge of variables important for such behavior in CD is therefore crucial. The aim of this study was to explore factors related to physical activity in individuals with cervical dystonia.MethodsSubjects included in this cross-sectional study were individuals diagnosed with CD and enrolled at neurology clinics (n = 369). Data was collected using one surface mailed self-reported questionnaire. Physical activity was the primary outcome variable, measured with the Physical Activity Disability Survey. Secondary outcome variables were: impact of dystonia measured with the Cervical Dystonia Impact Scale; fatigue measured with the Fatigue Severity Scale; confidence when carrying out physical activity measured with the Exercise Self-Efficacy Scale; confidence in performing daily activities without falling measured with the Falls Efficacy Scale; enjoyment of activity measured with Enjoyment of Physical Activity Scale, and social influences on physical activity measured with Social Influences on Physical Activity in addition to demographic characteristics such as age, education level and employment status.ResultsThe questionnaire was completed by 173 individuals (47 % response rate). The multivariate association between related variables and physical activity showed that employment, self-efficacy for physical activity, education level and consequences for daily activities explained 51 % of the variance in physical activity (Adj R 0.51, F (5, 162) = 35.611, p = 0.000). Employment and self-efficacy for physical activity contributed most strongly to the association with physical activity.ConclusionsConsidering the favorable consequences associated with physical activity it could be important to support the individuals with CD to remain in work and self-efficacy to physical activity as employment and self-efficacy had significant influence on physical activity level. Future research is needed to evaluate causal effects of physical activity on consequences related to CD .

Neurorehabilitation in dystonia: a holistic perspective

“…The most reported dystonic symptom barriers were pain, fatigue and poor balance. Zetterberg and colleagues (Zetterberg et al 2015 ) found that employment as well as self-efficacy for exercise had the greatest association with physical activity in their survey of over 350 people with cervical dystonia (Zetterberg et al 2015 ). Furthermore, many people with dystonia do not exercise as it tends to aggravate a range of dystonic symptoms (McCambridge et al 2019 ).…”

A survey of falls in people with dystonia

“…It has been suggested that gait and balance are impaired in people with cervical dystonia (CD), as walking speed (Barr et al, 2017;Esposito et al, 2017), cadence, step length (Esposito et al, 2017), stepping reaction time and functional performance (assessed by the timed up and go [TUG]) are reduced in comparison to healthy controls (Barr et al, 2017;Hoffland et al, 2014). People with CD also experience reduced balance confidence and fear falling (Barr et al, 2017;Hoffland et al, 2014;Zetterberg et al, 2015), scoring significantly higher on the Falls self-Efficacy Scale International, (FES-I) than a healthy control group (Barr et al, 2017). However, it is unknown if walking impairments or fear of falling contribute to actual falls in people with cervical or other presentations of dystonia.…”

Physical Activity, Sedentary Behavior, and Barriers to Exercise in People Living With Dystonia

“…Furthermore, an important component to understanding activity behaviors and encouraging PA in neurological populations is to investigate the impacts of, and barriers to, participation in PA or exercise. Only one study to date has investigated impacts on self-reported PA in people living with dystonia affecting the neck (termed cervical dystonia, CD) using a cross-sectional online survey (10). The study found being employed and having high levels of self-efficacy were major contributors to greater amounts of PA in people with CD (10).…”

“…Only one study to date has investigated impacts on self-reported PA in people living with dystonia affecting the neck (termed cervical dystonia, CD) using a cross-sectional online survey (10). The study found being employed and having high levels of self-efficacy were major contributors to greater amounts of PA in people with CD (10). However, the study did not determine actual PA levels undertaken by people with CD, nor did the authors address SB.…”