Quantifying daily physical activity and determinants in sedentary patients with Parkinson's disease

Dontje, Manon L.; Greef, M.H.G. de; Speelman, A.D.; Nimwegen, Marlies van; Krijnen, Wim P.; Stolk, Ronald P.; Kamsma, Y.P.T.; Bloem, Bastiaan R.; Munneke, Marten; Schans, Cees P. van der

doi:10.1016/j.parkreldis.2013.05.014

Cited by 69 publications

(65 citation statements)

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“…Dontje et al [14] reported that 586 PD patients showed a relevant but weak correlation between MMSE score and energy expenditure using actigraphy. Though our study did not reproduce this finding with statistical significance, descriptive values support their findings.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the exclusion of outliers with an arbitrary cutoff value bears a high risk of excluding patients with heavier disease burden. Moreover, several other studies have reported a considerable heterogeneity in advanced disease stages of both PD [14] and dementia [35,36,37]. …”

Section: Discussionmentioning

confidence: 99%

“…Those few studies indicate that late stage PD patients show longer bouts of sedentary behavior [13], and that energy expenditure is related to cognition [14]. However, these studies excluded patients with more advanced cognitive impairment [13,14].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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Background: For the early diagnosis of Parkinson disease dementia (PDD), objective home-based tools are needed to quantify even mild stages of dysfunction of the activities of daily living (ADL). Objectives: In this pilot study, home-based physical behavior was assessed to examine whether it is possible to distinguish mild cognitive impairment (PD-MCI) from PDD. Methods: Fifty-five patients with mild to severe Parkinson disease (PD) participated in this cross-sectional study. Based on comprehensive neuropsychological testing, PD patients were classified as cognitively nonimpaired (PD-NC), PD-MCI or PDD. For physical behavior assessments, patients wore the accelerometer DynaPort® (McRoberts) for 3 days. Ordinal logistic regression models with continuous Y were applied to correct results for motor impairment and depressive symptoms. Results: After excluding 7 patients due to insufficient wearing time, 48 patients with a mean of 2 recorded days were analyzed (17 PD-NC, 22 PD-MCI, 9 PDD). ADL-impaired PDD patients showed fewer sedentary bouts than non-ADL-impaired PD-MCI (p = 0.01, odds ratio [OR] = 8.9, 95% confidence interval [CI] = 1.8-45.2) and PD-NC (p = 0.01, OR = 10.3, CI = 1.6-67.3) patients, as well as a longer sedentary bout length (PD-NC: p = 0.02, OR = 0.1, CI = 0.02-0.65; PD-MCI: p = 0.02, OR = 0.14, CI = 0.03-0.69). These differences were mainly caused by fewer (PD-NC: p = 0.02, OR = 9.6, CI = 1.5-62.4; PD-MCI: p = 0.01, OR = 8.5, CI = 1.5-37.3) but longer sitting bouts (PD-NC: p = 0.03, OR = 0.12, CI = 0.02-0.80; PD-MCI: p = 0.04, OR = 0.19, CI = 0.04-0.93). Tests assessing executive function, visuoconstruction and attention correlated significantly with specific activity parameters (ρ ≥ 0.3; p < 0.05). Conclusion: Objective assessment of physical behavior, in particular the detection of sedentary bouts, is a promising contributor to the discrimination between PD-MCI and PDD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Specifically, they show that reduced ambulatory activity characterizes not only the most common NDD (namely PD), but - to a similar and even larger extent - atypical parkinsonian diseases such as PSP and degenerative coordination disorders such as DA. Given the growing burden of NDDs in our ageing societies [1] and the deleterious consequences of reduced physical activity [3,4,14], these findings have substantial implications for general health policy strategies and daily clinical care. They show that previous notions on the need for establishing behavioral activation and personalized coaching programs have to be extended and tailored from PD [6,28] to a broad spectrum of other NDDs.…”

Section: Discussionmentioning

confidence: 99%

“…We selected three disorders of the spectrum of NDD: (i) degenerative ataxia (DA) as a slowly progressive balance and coordination disorder of the cerebellum and its associated tracts; (ii) progressive supranuclear palsy (PSP) as a quickly progressive multisystemic disorder with a high load of motor, postural and cognitive dysfunction, and (iii) idiopathic PD as a slowly progressive movement disorder with large involvement of the basal ganglia. PD represents a common NDD of older people [9], where prior accelerometer-based activity data is already available [8,10,11,12,13,14], thus serving as a ‘reference NDD' for our comparative analysis. We hypothesized that (i) reduced ambulatory activity is not specific for PD but a feature shared across very different NDDs, and that (ii) ambulatory activity declines with increased disease duration in all NDDs, yet at a faster rate in PSP than in PD and DA.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory Activity Components Deteriorate Differently across Neurodegenerative Diseases: A Cross-Sectional Sensor-Based Study

Klenk

Srulijes²,

Schatton³

et al. 2016

Neurodegener Dis

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Background and Purpose: Reduced ambulatory activity is a major burden in neurodegenerative disease (NDD), leading to severe restrictions in social participation and further deterioration of motor capacities. However, objective evidence on walking behavior patterns and components underlying this impairment and its decline with disease progression is scarce for many NDDs. We aimed to unravel the detailed metrics underlying the reduced ambulatory activity in selected NDDs, and their relation to disease duration. We hypothesized that progressively reduced ambulatory activity is a feature shared across different NDDs, characterized by changes in both common and distinct components. Methods: Sixty-five subjects with NDD (n = 34 degenerative ataxia; n = 15 progressive supranuclear palsy, and n = 16 Parkinson's disease) and 38 healthy older adults (total n = 103) wore a three-axial accelerometer (activPAL3™) for 7 consecutive days. Detailed metrics of ambulatory activity were calculated. Results: The average daily walking duration was significantly decreased in all three NDDs, yet characterized by a differential pattern of changes in number and length of walking bouts and sit-to-stand transfers. Decline in walking duration progressed with increased disease duration in all three NDDs, yet at a differing rate. This decline was associated with progressive reductions in walking bout length and walking behavior pattern diversity in all three NDDs. Conclusions: These findings provide objective evidence that reduced ambulatory activity is a shared feature across different NDDs. Moreover, they reveal that several underlying walking behavior components change with increasing disease duration, yet at a differing rate in different NDDs. This indicates that metric analysis of ambulatory activity might provide ecologically relevant and disease-specific progression and outcome markers in several NDDs.

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Quantifying daily physical activity and determinants in sedentary patients with Parkinson's disease

Cited by 69 publications

References 24 publications

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

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

Ambulatory Activity Components Deteriorate Differently across Neurodegenerative Diseases: A Cross-Sectional Sensor-Based Study

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