Physical inactivity in Parkinson’s disease

Abstract

Patients with Parkinson’s disease (PD) are likely to become physically inactive, because of their motor, mental, and emotional symptoms. However, specific studies on physical activity in PD are scarce, and results are conflicting. Here, we quantified daily physical activities in a large cohort of PD patients and another large cohort of matched controls. Moreover, we investigated the influence of disease-related factors on daily physical activities in PD patients. Daily physical activity data of PD patients (n = 699) were collected in the ParkinsonNet trial and of controls (n = 1,959) in the Longitudinal Aging Study Amsterdam (LASA); data were determined using the LAPAQ, a validated physical activity questionnaire. In addition, variables that may affect daily physical activities in PD were recorded, including motor symptoms, depression, disability in daily life, and comorbidity. Patients were physically less active; a reduction of 29% compared to controls (95% CI, 10–44%). Multivariate regression analyses demonstrated that greater disease severity, gait impairment, and greater disability in daily living were associated with less daily physical activity in PD (R2 = 24%). In this large study, we show that PD patients are about one-third less active compared to controls. While disease severity, gait, and disability in daily living predicted part of the inactivity, a portion of the variance remained unexplained, suggesting that additional determinants may also affect daily physical activities in PD. Because physical inactivity has many adverse consequences, work is needed to develop safe and enjoyable exercise programs for patients with PD.

Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

“…Instead, walking behavior in everyday life can be measured using accelerometers, which are wearable devices measuring body acceleration during a specific wear‐time period (Matthews, Hagstromer, Pober, & Bowles, 2012). Measuring walking in everyday life is especially relevant in PD as this group are less physically active than people without the disease (van Nimwegen et al., 2011). While such objective gait assessments provide important information, they are not feasible in most clinical settings.…”

Main determinants of physical activity levels in individuals with Parkinson’s disease

“…Additionally, previous studies have explained only up to 28% of the variance of the level of physical activity of these individuals 2,5 . Knowledge of the factors that affect the level of physical activity of individuals with PD may guide clinicians that work with PD rehabilitation, and thereby prevent inactivity and its consequences.…”

“…A recent study indicated that individuals with PD are 29% less active than healthy individuals 2 . However, the ability of patients in the initial phase of PD to perform physical exercise may be comparable to that of healthy individuals when they maintain a certain level of regular physical activity.…”

“…Although the daily pattern of physical activity in the initial phase of the disease appears similar to that of controls 4 , this tends to change when PD progresses 4 . Recent studies have assessed factors that might play a role in the level of physical activity of PD patients 2,5 . Factors related to the disease such as severity of disease, levodopa daily dose and motor impairment level; factors related to the individual such as age and walking performance were pointed out as determinants of the physical activity level 2,5 .…”

“…Recent studies have assessed factors that might play a role in the level of physical activity of PD patients 2,5 . Factors related to the disease such as severity of disease, levodopa daily dose and motor impairment level; factors related to the individual such as age and walking performance were pointed out as determinants of the physical activity level 2,5 . Factors such as lower limb bradykinesia, clinical subtype and fatigue, that may decrease the level of physical activity in individuals with PD, have not yet been studied.…”