Self‐Reported Barriers to Exercise and Factors Impacting Participation in Exercise in Patients with Parkinson's Disease

Abstract

Exercise has proven benefits for symptoms of Parkinson's disease (PD), 1-3 but patients with PD (PWPD) report engaging in low levels of exercise. [4][5][6] Limited data suggest different reported barriers to exercise in PWPD and beliefs about exercise. [4][5][6] No study has examined whether the reported barriers and reports of participation differ depending on exercise type (ie, self-directed exercise, physical therapy [PT], or community-based exercise programs [CBP]). By surveying PWPD to obtain data on beliefs about the benefits of exercise, perceptions regarding barriers to different types of exercise, ratings of mood and disease severity, and participation in various exercise, we hoped to identify ways to potentially increase participation in exercise.During visits to Allegheny Health Network Movement Disorder clinics, 339 PWPD completed voluntary questionnaires (see File S1). Based loosely on American Health Academy guidelines, patients were grouped as greater exercisers (GE), defined as reporting exercising at least 150 minutes per week, versus lesser exercisers (LE). Data were tabulated as means and percentages. The t test, chi-square test, and Mann-Whitney U test were used to test for between-group differences. Stepwise logistic regression was used to determine the variables most predictive of exercise classification.Consistent with published data, 5,6 a majority of participants (86%) reported being encouraged to exercise and believing exercise was beneficial (90%). Low energy (36%), physical symptoms (33%), and fear of falling (30%) were the most frequently reported barriers for all types of exercise. Table 1 breaks down the most frequently reported barriers by exercise type. Referrals, reported participation rates, and barriers varied greatly between exercise types (Tables S3 and S4). Examining participation by referral rates showed that 90% of the 56% of PWPD reporting referrals also reported participating in PT versus 65% of the 43% referred to CBP. A majority of the participants (62%) reporting participation in PT reported continuing to do the learned exercises following PT. Estimated time exercising ranged from 0 to 840 min/week (mean = 136, standard deviation = 143). Only

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