Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity

Reed Handlery; Jill Campbell Stewart; Christine Pellegrini; Courtney Monroe; Garrett Hainline; Alicia Flach; Kaci Handlery; Stacy Fritz

doi:10.1093/ptj/pzab174

Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity

Phys Ther. 2021 Oct 1;101(10):pzab174. doi: 10.1093/ptj/pzab174.

Authors

Reed Handlery¹, Jill Campbell Stewart², Christine Pellegrini³, Courtney Monroe⁴, Garrett Hainline³, Alicia Flach², Kaci Handlery², Stacy Fritz²

Affiliations

¹ School of Physical Therapy, Arkansas Colleges of Health Education, Fort Smith, Arkansas, USA.
² Department of Exercise Science, Physical Therapy Program, University of South Carolina, Columbia, South Carolina, USA.
³ Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA.
⁴ Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA.

PMID: 34244805
DOI: 10.1093/ptj/pzab174

Abstract

Objective: People with Parkinson disease (PD) have low physical activity (PA) levels and are at risk for cardiovascular events. The 3 purposes of this study were to determine a step threshold that corresponds to meeting aerobic PA guidelines, determine effects of treadmill exercise on PA, and quantify the relationship between changes in daily steps and fitness.

Methods: This was a secondary analysis of the Study in Parkinson's Disease of Exercise trial, which randomized participants to high-intensity treadmill exercise, moderate-intensity treadmill exercise, or usual care for 6 months. Daily steps and moderate- to vigorous-intensity PA (MVPA) were assessed at baseline and once each month using an activity monitor. Fitness was assessed via graded exercise test at baseline and at 6 months. A step threshold that corresponds to meeting PA guidelines was determined by receiver operating characteristic curves. The effect of treadmill exercise on PA was examined in those below the step threshold (ie, the least active participants). Pearson r correlations determined the relationship between daily steps and fitness.

Results: Individuals with de novo PD (n = 110) were included. Those with ≥4200 steps were 23 times more likely (95% CI = 7.72 to 68) to meet PA guidelines than those with <4200 steps. For those with <4200 steps at baseline (n = 33), only those in the high-intensity exercise group increased daily steps (median of differences = 1250 steps, z = -2.35) and MVPA (median of differences = 12.5 minutes, z = -2.67) at 6 months. For those with <4200 steps, changes in daily steps were not associated with changes in fitness (r = .183).

Conclusion: In people with PD and <4200 daily steps at baseline, high-intensity treadmill exercise increased daily steps and MVPA, but these changes were not associated with changes in fitness.

Impact: People with PD should be encouraged to take ≥4200 daily steps to meet PA guidelines through walking.

Keywords: Parkinson; Physical Activity; Steps; Walking.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Exercise
Exercise Test / methods*
Exercise Therapy / methods*
Female
Fitness Trackers*
High-Intensity Interval Training
Humans
Male
Middle Aged
Parkinson Disease / physiopathology
Parkinson Disease / therapy*
Treatment Outcome
Walking / physiology*
Walking / psychology