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Ferrusola-Pastrana A, Fullerton CL, Meadows SN. Group-based exercise for Parkinson's: a qualitative study of participants and partners' perceptions of an exercise class delivered through a community-university collaboration. BMC Geriatr 2024; 24:488. [PMID: 38834963 DOI: 10.1186/s12877-024-05061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an ancillary therapeutic benefit to pharmacological management. This study explores the perceptions of exercising participants (PwP) and non-participating partners involved in an exercise class delivered through a community-university partnership. METHODS Two separate focus group discussions were conducted: one with class participants (PwP: n = 7, H&Y scale I to III), and the other with non-participating partners of PwP (n = 4). RESULTS Thematic analysis of the data identified that a range of physical, psychological and social factors were perceived to influence engagement: (1) actively taking control, (2) exercise is medicine for the mind and body, and (3) a community working together to promote exercise for parkinson's. Participants and partners felt that the support from the group, including the instructors and student volunteers, empowered and supported PwP to proactively self-manage their health, enjoy exercise in an inclusive group setting, and develop strong social connections with others in the local Parkinson's community. Support to exercise from healthcare professionals was identified as both an enabler and barrier to participation. CONCLUSIONS This study underscores the significance of a community-university partnership as a complementary therapeutic approach for PwP. It also provides critical reflections on its sustainability, including implications for how exercise is considered as medicine for PwP. Additionally, it offers practical recommendations to galvanise community participation and provide inclusive and viable exercise opportunities for PwP.
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Affiliation(s)
- Anna Ferrusola-Pastrana
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
- University School of Health and Sport (EUSES), University of Girona, Salt, Spain
| | - Christopher L Fullerton
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK.
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 7LA, UK.
| | - Stephen N Meadows
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
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Mañago MM, Swink LA, Hager ER, Gisbert R, Earhart GM, Christiansen CL, Schenkman M. The Impact of COVID-19 on Community-Based Exercise Classes for People With Parkinson Disease. Phys Ther 2021; 101:pzab203. [PMID: 34473303 PMCID: PMC8522385 DOI: 10.1093/ptj/pzab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE he purpose of the study was to determine the impact of novel coronavirus 2019 (COVID-19) restrictions on community-based exercise classes for people with Parkinson disease (PD) and their instructors. METHODS Data were collected via custom-designed electronic surveys for people with PD and class instructors who reported attending or teaching PD-specific exercise class ≥1 time/week for ≥3 months prior to pandemic restrictions (March 2020). The PD group also completed the Godin Leisure-Time Questionnaire, Self-Efficacy for Exercise scale, Schwab-England scale, and Parkinson's Disease Questionnaire 8. RESULTS Eighty-seven people with PD (mean = 70 [7.3] years old) and 43 instructors (51 [12.1] years old) from the United States completed surveys (October 2020 to February 2021). Mean Schwab-England (84 [16]) and Parkinson's Disease Questionnaire 8 (21 [15]) scores indicated low-to-moderate disability in the PD group. Ninety-five percent of the PD group had COVID-19 exposure concerns, and 54% reported leaving home ≤1 time/week. Although 77% of the PD group scored "active" on the Godin Leisure-Time Questionnaire, the mean Self-Efficacy for Exercise Scale score (55 [24]) indicated only moderate exercise self-efficacy, and >50% reported decreased exercise quantity/intensity compared with pre-COVID. There was decreased in-person and increased virtual class participation for both groups. The top in-person class barrier for the PD (63%) and instructor (51%) groups was fear of participant COVID-19 exposure. The top virtual class barriers were lack of socialization (20% of PD group) and technology problems (74% of instructor group). CONCLUSION During COVID-19, there has been less in-person and more virtual exercise class participation in people with PD and decreased exercise quantity and intensity. Virtual classes may not fully meet the needs of people with PD, and primary barriers include technology and lack of socialization. IMPACT As COVID-19 restrictions wane, it is imperative to help people with PD increase exercise and activity. The barriers, needs, and facilitators identified in this study might help inform approaches to increase participation in exercise and activity for people with PD. LAY SUMMARY During COVID-19, there has been less in-person and more virtual exercise class participation in people with PD and a decrease in exercise quantity and intensity. If you have PD, virtual classes might not fully meet your needs. Primary barriers may include technology problems and lack of social interaction.
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Affiliation(s)
- Mark M Mañago
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Laura A Swink
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Emily R Hager
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Robyn Gisbert
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Cory L Christiansen
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Margaret Schenkman
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
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Kwok JYY, Lee JJ, Auyeung M, Chan ML, Chan HYL. Letting nature take its course: A qualitative exploration of the illness and adjustment experiences of Hong Kong Chinese people with Parkinson's disease. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2343-2351. [PMID: 32519426 DOI: 10.1111/hsc.13055] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/05/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
Parkinson's disease (PD) is a chronic condition that results in not only physical deterioration but also a spectrum of psychosocial outcomes that demand continuous adjustment and coping. Previous qualitative research into the illness experiences has been conducted mainly in Western populations, yet little is known about Chinese PD patients' adjustment. The aims of this qualitative description study were to (a) understand the illness and adjustment experiences, (b) explore the reasons for psychological distress and (c) discern the adjustment strategies adopted along the course of illness, from the perspective of Hong Kong Chinese PD patients. Individual semi-structured interviews were conducted with 14 patients from January to June, 2016. Data were analysed using thematic analysis. Two themes emerged from the interviews: confronting the changes caused by Parkinson's disease and adjusting to living with Parkinson's disease. Participants reported experiencing turmoil due to progressive loss of functions and abilities, changes in role and identity and unattended emotional needs in the course of their illness. Considering the chronic and fluctuating nature of PD, rehabilitation programs should be applied to address not only the physical symptoms but also the psychological needs of PD patients. Behavioral strategies facilitating active health behaviours and accommodative psychological adjustment are salient to facilitate the holistic well-being of PD patients.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong, Hong Kong SAR
| | - Man Lee Chan
- North Lantau Hospital, Hospital Authority, Lantau, Hong Kong SAR
| | - Helen Yue Lai Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
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Building Capacity of Evidence-Based Public Health Practice at King Saud University: Perceived Challenges and Opportunities. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 26:428-433. [DOI: 10.1097/phh.0000000000001164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Structured Care and Self-Management Education for Persons with Parkinson's Disease: Why the First Does Not Go without the Second-Systematic Review, Experiences and Implementation Concepts from Sweden and Germany. J Clin Med 2020; 9:jcm9092787. [PMID: 32872258 PMCID: PMC7563525 DOI: 10.3390/jcm9092787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
Integrated care is regarded as a key for care delivery to persons with chronic long-term conditions such as Parkinson’s disease. For persons with Parkinson’s disease, obtaining self-management support is a top priority in the context of integrated care. Self-management is regarded as a crucial competence in chronic diseases since the affected persons and their caregivers inevitably take up the main responsibility when it comes to day-to-day management. Formal self-management education programs with the focus on behavioral skills relevant to the induction and maintenance of behavioral change have been implemented as a standard in many chronic long-term conditions. However, besides the example of the Swedish National Parkinson School, the offers for persons with Parkinson’s disease remain fragmented and limited in availability. Today, no such program is implemented as a nationwide standard in Germany. This paper provides (1) a systematic review on structured self-management education programs specifically designed or adopted for persons with Parkinson’s disease, (2) presents the Swedish National Parkinson School as an example for a successfully implemented nationwide program and (3) presents a concept for the design, evaluation and long-term implementation of a future-orientated self-management education program for persons with Parkinson’s disease in Germany.
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Saturdays-in-Motion: Education and Empowerment through an Interdisciplinary Team Approach for Parkinson's Disease in Cali-Colombia. PARKINSONS DISEASE 2020; 2020:2497386. [PMID: 32733667 PMCID: PMC7378612 DOI: 10.1155/2020/2497386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/27/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
Introduction Parkinson's disease (PD) is one of the most prevalent age-related neurodegenerative disorders. The progression of PD produces an important disease burden in patients due to functional impairment, which also has repercussions on caregivers. In addition, it has become a challenge for health systems, especially in developing countries, which have limited resources. Multidisciplinary teams with a community approach have proved effective in high-income countries; however, there is no reported literature in low- and middle-income countries about this kind of initiative. Objective This paper aims to document the experience of patients, caregivers, and experts in a community approach as an innovative model in a middle-income country. Methods A quantitative descriptive research was conducted. The selection criteria were having a PD diagnosis, attending with a caregiver to Saturdays in Motion (SIM), or being a clinical expert invited to SIM. PD patients and their caregivers answered three surveys on their points of view with respect to SIM: SIM and their quality of life (QoL) and PDQ-39 and Zarit, whereas clinical experts completed two questions related to the SIM program. Descriptive statistics were used to summarize the results of the surveys and clinical tests. Results Forty-eight, twenty-four, and twenty-one subjects answered surveys one, two, and three, respectively. In total, four clinical experts were interviewed. 87.9% of the patients consider that SIM activities improved their QoL. The most affected areas in PDQ-39 were those related to the social area. Around 66.6% of the caregivers reported a mild burden on Zarit and think that SIM enhances the PD patient's QoL. Clinical experts highlighted the sense of community and empathy. Conclusion Our preliminary experience shows a multidisciplinary model with a community approach which redefines the traditional relationship between patients, caregivers, and clinical experts. This aim of this initiative is that education and empowerment patients and caregivers reach a better perception of QoL.
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Domingos J, Radder D, Riggare S, Godinho C, Dean J, Graziano M, de Vries NM, Ferreira J, Bloem BR. Implementation of a Community-Based Exercise Program for Parkinson Patients: Using Boxing as an Example. JOURNAL OF PARKINSONS DISEASE 2020; 9:615-623. [PMID: 31282426 PMCID: PMC6839476 DOI: 10.3233/jpd-191616] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Persons with Parkinson's disease (PD) benefit from continuous exercise through participation in community-based exercise programs. However, community programs often lack PD-specific knowledge needed to provide safe and adequately dosed exercise. OBJECTIVE To evaluate the acceptability and safety of a PD-specific boxing program in the community. METHODS We developed specific educational resources to facilitate the boxing instructors. We also organized an educational and practical workshop for patients (n = 26) and instructors (n = 10), and assessed: (a) participants' satisfaction; (b) instructors' appreciation of the educational resources; and (c) numbers of patients interested in participating in the boxing program. After 18 months, patients and instructors completed a questionnaire evaluating: (a) participants' satisfaction; (b) adverse events; (c) facilitators and barriers; and (d) proportion of participants at follow-up. RESULTS Twenty-six persons with PD (62% men) and 10 boxing instructors participated in the workshop. 81% of patients and 80% of instructors were very satisfied. Instructors found the educational materials "very helpful" (60%) or "helpful" (40%). Patients expressed a clear interest (54%) or possible interest (46%) in the program. We initiated classes with 10 participants. At 18-months follow-up, the program consisted of four boxing sessions/week, led by three instructors, with 40 participants. Seventeen patients responded to the questionnaire at follow-up. Participants were "very satisfied" (53%), "satisfied" (35%) and neither satisfied nor unsatisfied (12%) with the program. Adverse effects were mild (e.g., muscle aches). Transportation and physical disability were the main barriers for participation. CONCLUSIONS The boxing program was well-received, with increasing numbers of participants at 18 months. The educational resources can support boxing instructors participating in current and future boxing classes being delivered in the community.
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Affiliation(s)
- Josefa Domingos
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.,Department of Sport and Health, Laboratory of Motor Behavior, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Danique Radder
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Sara Riggare
- Department for Learning, Health Informatics Centre, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Godinho
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | | | | | - Nienke M de Vries
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joaquim Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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Tidman M, Skotzke E. Effects of a community-based exercise program on mobility, balance, cognition, sleep, activities of daily living, and quality of life in PD: a pilot study. Neurodegener Dis Manag 2020; 10:27-39. [PMID: 32031050 DOI: 10.2217/nmt-2019-0027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: The primary objective of the study was to evaluate the effects of a community-based exercise program for adults with Parkinson's disease (PD). Patients & methods: This one-group pretest and post-test design involved 22 participants with PD who participated in two to three exercise sessions per week for 8 weeks. Outcomes assessed for statistical significance included balance, mobility, cognition, activities of daily living, sleep and quality of life. Results: Although exercise is positively correlated with improvements in function, this short-duration study did not demonstrate this. Qualitative themes revealed an increase in self-perceived socialization, coordination and motivation to continue exercise. Conclusion: This community-based exercise study showed improvements in socialization, self-reported coordination and motivation to exercise. Further research is needed to assess community exercise interventions for PD.
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Affiliation(s)
- Melanie Tidman
- Department of Health Sciences, College of Graduate Health Studies, A.T. Still University, Mesa, AZ, USA
| | - Erin Skotzke
- Department of Occupational Therapy, Nova Southeastern University, Fort Lauderdale, FL, USA
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Borchers EE, McIsaac TL, Bazan-Wigle JK, Elkins AJ, Bay RC, Farley BG. A physical therapy decision-making tool for stratifying persons with Parkinson's disease into community exercise classes. Neurodegener Dis Manag 2019; 9:331-346. [PMID: 31686582 DOI: 10.2217/nmt-2019-0019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aim: Physical therapy and exercise are considered essential components in the management of Parkinson's disease (PD). Using our retrospective data and years of experience in assigning persons with PD to multilevel group classes we propose a two-part physical therapy decision-making tool consisting of participant and exercise program considerations. Methods: Retrospective medical record review and therapist consensus identified evaluation considerations determined to aide clinical decision making. The ability of these variables (i.e., demographics, clinical characteristics, clinical measures cut-offs) to predict the class assignment decision of PD-specialized physical therapists was evaluated using discriminant function analysis. Results: Therapist-assigned groups differed significantly on all clinical measures (p < 0.001) which provided the categorical data required for discriminant analysis. Using all variables, the discriminant function analysis predicted class assignment of the therapists with 79% agreement. Conclusion: This proposed tool provides a framework that may guide the process for increasing access to multilevel group classes.
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Affiliation(s)
- Emily E Borchers
- NeuroFit Networks, Inc. DBA Parkinson Wellness Recovery
- PWR!, 3849 E. Broadway Blvd. STE163, Tucson, AZ 85716, USA
| | - Tara L McIsaac
- Department of Physical Therapy, Arizona School of Health Sciences, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206, USA
| | - Jennifer K Bazan-Wigle
- NeuroFit Networks, Inc. DBA Parkinson Wellness Recovery
- PWR!, 3849 E. Broadway Blvd. STE163, Tucson, AZ 85716, USA
| | - Aaron J Elkins
- NeuroFit Networks, Inc. DBA Parkinson Wellness Recovery
- PWR!, 3849 E. Broadway Blvd. STE163, Tucson, AZ 85716, USA
| | - Ralph C Bay
- Department of Interdisciplinary Sciences, Arizona School of Health Sciences, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206, USA
| | - Becky G Farley
- NeuroFit Networks, Inc. DBA Parkinson Wellness Recovery
- PWR!, 3849 E. Broadway Blvd. STE163, Tucson, AZ 85716, USA
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Colón-Semenza C, Latham NK, Quintiliani LM, Ellis TD. Peer Coaching Through mHealth Targeting Physical Activity in People With Parkinson Disease: Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e42. [PMID: 29449201 PMCID: PMC5832905 DOI: 10.2196/mhealth.8074] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/30/2017] [Accepted: 12/14/2017] [Indexed: 01/06/2023] Open
Abstract
Background Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. Objective The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. Methods A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Results Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs completed the 8 weekly phone conversations. There were no adverse events over the course of the study. All peer coaches were “satisfied” or “very satisfied” with the training program, and all participants were “satisfied” or “very satisfied” with the peer-mentored walking program. All participants would recommend this program to others with PD. Increases in average steps per day exceeding the clinically important difference occurred in 4 out of the 5 mentees. Conclusions Remote peer coaching using mHealth is feasible, safe, and acceptable for persons with PD. Peer coaching using mHealth technology may be a viable method to increase physical activity in individuals with PD. Larger controlled trials are necessary to examine the effectiveness of this approach.
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Affiliation(s)
- Cristina Colón-Semenza
- Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Nancy K Latham
- Boston Claude D Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Lisa M Quintiliani
- School of Medicine, Department of Medicine, Section of General Internal Medicine, Boston University, Boston, MA, United States
| | - Terry D Ellis
- Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
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Swank C, Shearin S, Cleveland S, Driver S. Auditing the Physical Activity and Parkinson Disease Literature Using the Behavioral Epidemiologic Framework. PM R 2016; 9:612-621. [PMID: 27777097 DOI: 10.1016/j.pmrj.2016.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/04/2016] [Accepted: 10/07/2016] [Indexed: 11/26/2022]
Abstract
Motor and nonmotor symptoms associated with Parkinson disease place individuals at greater risk of sedentary behaviors and comorbidities. Physical activity is one modifiable means of improving health and reducing the risk of morbidity. We applied a behavioral framework to classify existing research on physical activity and Parkinson disease to describe the current evolution and inform knowledge gaps in this area. Research placed in phase 1 establishes links between physical activity and health-related outcomes; phase 2 develops approaches to quantify physical activity behavior; phase 3 identifies factors associated with implementation of physical activity behaviors; phase 4 assesses the effectiveness of interventions to promote activity; and phase 5 disseminates evidence-based recommendations. Peer-reviewed literature was identified by searching PubMed, Google Scholar, and EBSCO-host. We initially identified 287 potential articles. After further review, we excluded 109 articles, leaving 178 included articles. Of these, 75.84% were categorized into phase 1 (n = 135), 10.11% in phase 2 (n = 18), 9.55% into phase 3 (n = 17), 3.37% into phase 4 (n = 6), and 1.12% into phase 5 (n = 2). By applying the behavioral framework to the physical activity literature for people with Parkinson disease, we suggest this area of research is nascent with more than 75% of the literature in phase 1. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Chad Swank
- School of Physical Therapy, Texas Woman's University, 5500 Southwestern Medical Ave, Dallas, TX 75235-7299(∗).
| | - Staci Shearin
- Department of Physical Therapy, University of Texas Southwestern School of Health Professions, Dallas, TX(†)
| | | | - Simon Driver
- Baylor Institute for Rehabilitation, Dallas, TX(§)
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12
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Shanahan J, Bhriain ON, Morris ME, Volpe D, Clifford AM. Irish set dancing classes for people with Parkinson's disease: The needs of participants and dance teachers. Complement Ther Med 2016; 27:12-7. [PMID: 27515870 DOI: 10.1016/j.ctim.2016.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE As the number of people diagnosed with Parkinson's disease increases, there is a need to develop initiatives that promote health and wellbeing and support self-management. Additionally, as exercise may slow physical decline, there is a need to develop methods that facilitate greater engagement with community-based exercise. The aim of this study is to examine the needs of (1) people with Parkinson's disease and (2) set dancing teachers to enable the development of participant-centred community set dance classes. METHODS A mixed methods study design was used. Two consensus group discussions using nominal group technique were held to (1) identify factors pertaining to the needs of people with Parkinson's disease from a set dance class and (2) the educational needs of set dancing teachers to enable them to teach set dancing to people with Parkinson's disease. Group discussions began with silent generation of ideas. A round-robin discussion and grouping of ideas into broader topic areas followed. Finally, participants ranked, by order of priority (1-5), the topic areas developed. Final data analysis involved summation of participants' ranking scores for each topic area. RESULTS Rich information on the needs of people with Parkinson's disease from a dance class and the educational guidance sought by set dancing teachers was gathered. Topic areas developed include "teaching method" for set dances and "class environment". CONCLUSION Accessing community exercise programmes is important for this population. The results of this study will inform the development of an educational resource on Parkinson's disease for set dancing teachers. This resource may facilitate a larger number of teachers to establish sustainable community set dancing classes for people with Parkinson's disease.
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Affiliation(s)
- Joanne Shanahan
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland.
| | - Orfhlaith Ní Bhriain
- Irish World Academy of Music and Dance, Department of Arts Humanities and Social Sciences, University of Limerick, Co. Limerick, Ireland
| | - Meg E Morris
- Department of Physiotherapy, School of Allied Health, La Trobe University, Bundoora 3086, Australia
| | - Daniele Volpe
- Department of Neurorehabilitation, Casa di Cura Villa Margherita, Vicenza, Italy
| | - Amanda M Clifford
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Co. Limerick, Ireland
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States RA, Sweeny TL, Rossi A, Spierer DK, Salem Y. Physical Functioning After 1, 3, and 5 Years of Exercise Among People With Parkinson's Disease: A Longitudinal Observational Study. J Geriatr Phys Ther 2016; 40:127-134. [PMID: 27058217 DOI: 10.1519/jpt.0000000000000084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Regular physical activity is thought to be crucial to maintaining optimal physical function in people with Parkinson's disease (PWP), and it may have neuroprotective effects. As with many medical treatments, exercise is most effective when performed consistently over a period of years. The primary aim of this study was to examine multiyear adherence to a community-based group exercise program for PWP. A secondary aim was to document how physical functioning progressed after 1, 3, and 5 years for participants who consistently attended a community-based, group, exercise program. METHODS Forty-six individuals with idiopathic Parkinson's disease, who were at modified Hoehn and Yahr stage I, II, or III and were community ambulators, were recruited on a rolling basis between 2008 and 2013. Each provided yearly medical clearance to exercise. Participants engaged in a free, community-based, group exercise program offered 2 days per week, 1 hour per day, for three 10-week sessions per year. The program included supervised floor exercises for balance, coordination, strength, and flexibility along with resistance training on dual-action exercise machines. Participants who attended more than half the classes for 1, 3, or 5 years (n = 27, n = 14, n = 7, respectively) were considered to have completed the fitness program (consistent exercisers) and were included in the longitudinal data analysis; participants who either dropped out or attended less than half the classes (n = 19) were not included. Physical functioning was evaluated at baseline for all participants and yearly thereafter for consistent exercisers. Wilcoxon signed rank tests were used to compare baseline data with data collected after 1, 3, and 5 years of consistent exercise. RESULTS AND DISCUSSION Over half of the participants initially evaluated completed at least 1 year of the fitness program (27 of the 46 = 59%) and a proportion completed 3 years (14 of the 39 = 39%), and 5 years (7 of the 24 = 29%). At baseline, consistent exercisers were younger than those who dropped out (63.9 vs 69.9 years, P < .05), but had similar modified Hoehn and Yahr medians (2.0 vs 2.3), and similar time since diagnosis (8.0 vs 5.6 years). Consistent exercisers showed small statistically significant improvements in grip strength (8.9% change), Berg Balance scores (5.1% change), and 6-minute walk test (11% change) from baseline to year 1. No significant differences were found in these variables after 3 or 5 years, or for gait speed and timed up and go after 1, 3, or 5 years. CONCLUSION Despite the progressive nature of Parkinson's disease, many PWP can sustain a regular program of varied modes of community-based, group exercise over a period of years. Participants who did so maintained initial performance levels on key measures of physical functioning. By working with an interprofessional team in a supportive community-based exercise program, physical therapists can help many PWP engage in consistent and sustained exercise activity over multiyear periods.
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Affiliation(s)
- Rebecca A States
- 1Long Island University-Brooklyn, Brooklyn, New York. 2University of North Texas Health Science Center, Fort Worth, Texas
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Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research. Phys Ther 2016; 96:410-7. [PMID: 26251479 DOI: 10.2522/ptj.20140529] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 08/02/2015] [Indexed: 11/17/2022]
Abstract
In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted.
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Enhanced Exercise Therapy in Parkinson's disease: A comparative effectiveness trial. J Sci Med Sport 2015; 19:12-7. [PMID: 25709055 PMCID: PMC4529399 DOI: 10.1016/j.jsams.2015.01.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 12/27/2014] [Accepted: 01/15/2015] [Indexed: 11/21/2022]
Abstract
Objectives Exercise can improve motor function in people with Parkinson’s disease but depression reduces the motivation to participate in regular exercise. The aim of this study was to develop a novel Enhanced Exercise Therapy program that uses manual-driven guided exercise and peer-facilitated psychoeducation for individuals with Parkinson’s disease and depression. Design 24 week randomized controlled design. Methods Thirty individuals were randomized to Enhanced Exercise Therapy or self-guided therapy, and evaluated at baseline, 12-weeks and at 24-weeks. Enhanced Exercise Therapy included group exercise and group psychoeducation for 12 weeks. Between 13–24 weeks, individuals had access to the fitness facility but group sessions were not held. Self-guided therapy included written guidelines for a self-paced exercise program and psychoeducation. Primary outcome measures included the number of exercise sessions and International Physical Activity Questionnaire score. Secondary measures included resting heart rate, supine blood pressure, estimated VO2max and incidence of orthostatic hypotension. Results Twenty four individuals completed the study (80% retention) and both groups attended similar number of exercise sessions. There were no significant changes in cardiovascular fitness measures but there was a significant increase in the amount of physical activity in the Enhanced Exercise Therapy group and a decrease in the self-guided therapy group during the post-intervention period. Conclusions Enhanced exercise therapy appears to promote engagement in an exercise program and more physical activity, even after group sessions were concluded in individuals with Parkinson’s disease and depression.
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Shanahan J, Morris ME, Bhriain ON, Volpe D, Richardson M, Clifford AM. Is Irish set dancing feasible for people with Parkinson's disease in Ireland? Complement Ther Clin Pract 2015; 21:47-51. [DOI: 10.1016/j.ctcp.2014.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022]
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van Wegen EEH, Hirsch MA, Huiskamp M, Kwakkel G. Harnessing Cueing Training for Neuroplasticity in Parkinson Disease. TOPICS IN GERIATRIC REHABILITATION 2014. [DOI: 10.1097/tgr.0000000000000005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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