Perceived Exercise Habits of Individuals with Parkinson’s Disease Living in the Community

Context Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise. Objective To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand the impact of perceived intensity on daily exercise practices. Design, setting, participants One hundred thirty-eight individuals with PD living in the community were surveyed online regarding their current exercise habits. Main outcome measure A total of 22 questions aimed to understand exercise selection, focus, and perceived intensity. Questions asked basic demographic, symptom presentation and management of disease related symptoms that were present while living with PD. Exercise questions focused understanding participants current function level, practice exercise habits and perceived levels of exercise intensity during daily routines. Results Of the 138 individuals surveyed for this preliminary study, eighty-seven percent of individuals with PD participated in exercise with seventy-five percent choosing walking as a mode for exercise. Sixty-five percent of the respondents noted that despite exercise, their walking speed and endurance has worsened since diagnosis. Eighty-one percent perceived exercising at moderate intensity levels, however little provocation of intensity symptoms was noted. Conclusion Our preliminary study survey results suggest that individuals with PD are exercising but not at high enough intensity levels to promote improvements in gait performance. Individuals with PD may need to be pushed at higher intensity levels, beyond their voluntary limits, to induce gait performance changes. These findings can provide a foundation for future fitness interventions within this population to target improving gait

CHANGING THE PERSPECTIVE IN MANAGEMENT OF A PROGRESSIVE NEUROLOGICAL DISORDER: DEVELOPING INTERVENTIONS TO TARGET MULTIFACTORIAL COMPONENTS OF PARKINSON’S DISEASE WITH EMPHASIS ON IMPROVING CLINICAL MEANINGFUL OUTCOMES

Neurological disorders are currently the leading source of disability in the United States with Parkinson’s disease (PD) having the fastest growing incidence rate (Abate et al., 2017). PD is the second most common degenerative disease in older adults above 60 years old (Tysnes & Storstein, 2017) and epidemiology reports predict that the number of PD cases has doubled to 6 million since 1990 (Dorsey, Sherer, et al., 2018) It is estimated that PD prevalence will continue to rise with a projected 60,000 new cases in the United States by 2030 (Dorsey, Elbaz, et al., 2018) and has the potential to reach more than 12 million cases worldwide by 2040 (Dorsey, Sherer, et al., 2018). PD is an incurable, progressive neurological disorder, that presents with both motor and non-motor symptoms that effects one’s functional mobility potential. The multifactor impact of PD, including both motor and non-motor features, has a negative effect on functional mobility potential for individuals living with PD. Walking, a component of functional mobility, becomes more difficult as the disease progresses. A once previously learned automated task, is compromised secondary to a variety of motor deficits. In addition, non-motor symptoms can worsen motor complications, gait difficulties, disability, and self-perceived health status (Dissanayaka et al., 2010; Pontone et al., 2009; Yamanishi et al., 2013). Due to the various components of this disease, it can be difficult to choose which interventions would be most beneficial for individuals with PD that are presenting with walking problems. The overall purpose of this research is to first explore the exercise habits of individuals with PD to understand what type of exercise is being utilized to combat this progressive neurodegenerative disorder that currently has no cure. It will aim to understand how intense individuals are perceiving their workouts and what barriers exist to PD symptom management. Neuroplastic fundamentals suggest that specificity of selected exercise, repetition of activities and intensity of work can all positively impact direct recovery after a neurological diagnosis. Furthermore, incorporating exercise at higher intensities has been established as an intervention to improve functional mobility for individuals with stroke, traumatic brain injury and spinal cord injury but little is known about its impact with the PD population. This research will build on the knowledge gained about current exercise habits and couple it with current best evidence to develop an intervention that targets improving clinically meaningful outcomes with goals to address the multifactorial components of PD