Development of a community-based golf and exercise program for people with Parkinson's disease

Exploring public perceptions and awareness of Parkinson's disease: A scoping review

BACKGROUND

Parkinson's disease (PD) is a common neurological disease affecting around 1% of people above sixty years old. It is characterised by both motor and non-motor symptoms including tremor, slow movement, unsteady gait, constipation and urinary incontinence. As the disease progresses, individuals living with the disease are likely to lose their independence and autonomy, subsequently affecting their quality of life. People with PD should be supported to live well within their communities but there has been limited research regarding what the public know about PD. This review aims to develop an understanding of how the public view people living with PD, which has the potential to aid the development of an educational resource for the future to improve public awareness and understanding of PD. The purpose of this scoping review is to review and synthesise the literature on the public perception and attitudes towards people living with PD and identify and describe key findings.

AIM

This scoping review aims to explore public perceptions and awareness of Parkinson's Disease among diverse populations, encompassing beliefs, knowledge, attitudes, and the broader societal context influencing these perceptions.

METHODS

A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for ScR (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO and International Bibliography of the Social Sciences). The Joanna Briggs Institute Critical Appraisal Tools (JBI) were used to assess the quality of primary studies, however, all relevant studies were considered regardless of their methodological quality. The 'Population-Concept-Context' framework was used in the screening process to identify eligible papers.

RESULTS

A total of 23 studies were included in the review representing global research in quantitative (n = 12) and mixed methods approaches (n = 11). All 23 studies adopted some aspect of cross-sectional design. Three themes emerged from the studies, the first being public knowledge of symptoms, causes and treatment of PD and this highlighted a lack of understanding about the disease. Secondly, the review identified public attitudes towards PD, highlighting the social consequences of the disease, including the association between PD and depression, isolation and loss of independence. Finally, the third theme highlighted that there was a paucity of educational resources available to help increase public understanding of PD.

CONCLUSION

Findings from this scoping review have indicated that public awareness of PD is a growing area of interest. To our knowledge, this is the first scoping review on this topic and review findings have indicated that public knowledge and attitudes towards PD vary internationally. The implications of this are that people with PD are more likely to be a marginalised group within their communities. Future research should focus on understanding the perception of the public from the perspective of people with PD, the development of interventions and awareness campaigns to promote public knowledge and attitude and further high-quality research to gauge public perceptions of PD.

Community-based high-intensity cycling improves disease symptoms in individuals with Parkinson's disease: A six-month pragmatic observational study

Participation in supervised, laboratory-based aerobic exercise protocols holds promise in slowing the progression of Parkinson's disease (PD). Gaps remain regarding exercise adherence and effectiveness of laboratory protocols translated to community-based programs. The aim of the project was to monitor exercise behaviour and evaluate its effect on disease progression over a 6 month period in people with PD participating in a community-based Pedalling for Parkinson's (PFP) cycling program. A pragmatic, observational study design was utilised to monitor exercise behaviour at five community sites. The Movement Disorders Society-Unified Parkinson's disease Rating Scale Motor III (MDS-UPDRS-III) and other motor and non-motor outcomes were gathered at enrollment and following 6 months of exercise. Attendance, heart rate, and cadence data were collected for each exercise session. On average, people with PD (N = 41) attended nearly 65% of the offered PFP classes. Average percent of age-estimated maximum heart rate was 69.3 ± 11.9%; average cadence was 74.9 ± 9.0 rpms. The MDS-UPDRS III significantly decreased over the 6-month exercise period (37.2 ± 11.7 to 33.8 ± 11.7, p = 0.001) and immediate recall significantly improved (42.3 ± 12.4 to 47.1 ± 12.7, p = 0.02). Other motor and non-motor metrics did not exhibit significant improvement. Participants who attended ~74% or more of available PFP classes experienced the greatest improvement in MDS-UPDRS III scores; of those who attended less than 74% of classes, cycling greater than or equal to 76 rpms lead to  improvement. Attendance and exercise intensity data indicated that a laboratory-based exercise protocol can be successfully translated to a community setting. Consistent attendance and pedalling at a relatively high cadence may be key variables to PD symptom mitigation. Improvement in clinical ratings coupled with lack of motor and non-motor symptom progression over 6 months provides rationale for further investigation of the real-world, disease-modifying potential of aerobic exercise for people with PD.

Individuals With Parkinson Disease Are Adherent to a High-Intensity Community-Based Cycling Exercise Program

BACKGROUND AND PURPOSE

Parkinson disease is a progressive neurological disorder with no known cure or proven method of slowing progression. High-intensity, laboratory-based aerobic exercise interventions are currently being pursued as candidates for altering disease progression. The aim of this project was to evaluate the translation of a laboratory-based intervention to the community by monitoring exercise adherence (eg, attendance) and intensity (eg, heart rate [HR] and cadence) in 5 established Pedaling for Parkinson's exercise classes. A secondary aim was to determine the impact of disease severity and demographics variables on exercise adherence.

METHODS

A 12-month pragmatic design was utilized to monitor attendance, HR, and cadence during each Pedaling for Parkinson's class session. Over the course of 1 year, approximately 130 sessions were offered. Forty-nine (n = 30 males) persons with mild to moderate Parkinson disease from 5 community fitness facilities participated.

RESULTS

Out of the approximately 130 cycling sessions offered at each site over 12 months, 37% of the participants attended greater than 2 classes per week (80-130 total sessions), 47% attended 1 to 1.9 classes per week (40-79 total sessions), and less than 17% attended less than 1 class per week (<40 total sessions). Average pedaling cadence was 74.1 ± 9.6 rpms while average percentage of HR maximum was 68.9 ± 12.0%. There were no significant differences between cycling adherence and intensity variables based on disease severity, age, or sex.

DISCUSSION AND CONCLUSIONS

Consistent attendance and exercise performance at moderate to high intensities are feasible in the context of a community-based Pedaling for Parkinson's class. Consistency and intensity of aerobic exercise have been proposed as critical features to elicit potential disease modification benefits associated with exercise. Community-based fitness programs that bring laboratory protocols to the "real world" are a feasible intervention to augment current Parkinson disease treatment approaches. See the Supplementary Video, available at: http://links.lww.com/JNPT/A357.

A Retrospective Analysis of Group-Based Boxing Exercise on Measures of Physical Mobility in Patients With Parkinson Disease

Objectives: The purpose of this retrospective study is to further the limited body of evidence regarding the effects of a group-based boxing intervention for those with Parkinson’s disease (PD).

Design: A retrospective cohort study was performed analyzing data collected on outcome measures at 6-month intervals up to 2 years. Individuals participated in the standardized “Rock Steady Boxing” (RSB) program for up to 24 months. Every 6 months, measures were taken of balance (Fullerton Advanced Balance [FAB] Scale), functional mobility (Timed-Up and Go [TUG]), lower extremity strength (30-second Chair Stand [30CST]), and gait speed (10 Meter Walk Test [10MWT]).

Methods: Statistical significance ( P < .05) was determined by a two-tailed t test. Data were collected from RSB-affiliated programs at 4 locations across the southeastern United States. Current and/or past participants in RSB with baseline and at least one subsequent outcome measure were included, resulting in 68 participants (54 male, 14 female, and mean age of 71.2 years ± 8.56 standard deviation).

Results: Statistically significant improvements in FAB scale, TUG, and 30CST over time were found at both 6- and 12-month time points. Significant changes continued through 18 months for FAB and 30CST. No significant changes in 10MWT were observed; however, a moderate effect size was observed at the 1-year point.

Conclusions: Participants with PD were able to achieve statistically significant improvements in standard measures of functional mobility, balance, and strength within the timeline of this study. Limitations include the retrospective nature, an inability to monitor adherence, and lack of control over pharmaceutical or other interventions.

Living with Parkinson's disease: The benefits of community programming

BACKGROUND

and purpose. Parkinson's Disease (PD) is a common neurodegenerative disorder that has significant physical, mental and financial costs for individuals and families. It is necessary to examine ways to improve the lives of individuals living with PD.

MATERIALS AND METHODS

Through the use of a thematic analysis, this study examined the benefits that participants in a community PD program experienced, and the barriers that prohibited individuals from participating.

RESULTS

Participants of the community PD program reported that participating in the program gave them a sense of community/belonging, increased knowledge about PD, a sense of hope/improved outlook on life, and physical improvements. Two main barriers preventing individuals from participating in the program was a lack of transportation and a fear of seeing PD symptom progression in others.

CONCLUSION

Results highlight that community PD programs can aid in improvements in quality of life related to exercise, an improved outlook, and support.