Understanding physical activity in Veterans with Parkinson disease: A mixed-methods approach

Sneha Mantri; Stephanie Wood; John E Duda; James F Morley

doi:10.1016/j.parkreldis.2018.10.023

Understanding physical activity in Veterans with Parkinson disease: A mixed-methods approach

Parkinsonism Relat Disord. 2019 Apr:61:156-160. doi: 10.1016/j.parkreldis.2018.10.023. Epub 2018 Oct 23.

Authors

Sneha Mantri¹, Stephanie Wood², John E Duda³, James F Morley³

Affiliations

¹ Parkinson Disease Research, Education, and Clinical Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Mailstop 127, Philadelphia PA 19104, USA; Department of Neurology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, 2nd Floor SPE, Philadelphia PA 19104, USA; Department of Neurology, Duke University Medical Center, DUMC 3333, 932 Morreene Road, Durham NC 27705, USA. Electronic address: Sneha.Mantri@duke.edu.
² Parkinson Disease Research, Education, and Clinical Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Mailstop 127, Philadelphia PA 19104, USA.
³ Parkinson Disease Research, Education, and Clinical Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Mailstop 127, Philadelphia PA 19104, USA; Department of Neurology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, 2nd Floor SPE, Philadelphia PA 19104, USA.

PMID: 31036158
DOI: 10.1016/j.parkreldis.2018.10.023

Abstract

Introduction: Physical activity is critical in Parkinson disease (PD) management, but barriers and motivators of activity in Veterans with PD may be unique. We examined activity habits, including barriers and motivators, in this population.

Methods: Participants completed the Physical Activity Scale in the Elderly (PASE). Compliance with American Heart Association (AHA) recommendations was assessed. Veterans also completed the Exercise Perceptions Questionnaire (EPQ), assessing knowledge, barriers, and motivators of activity. Free-text barriers/motivators were analyzed by the overlapping clusters method.

Results: Seventy-five Veterans were recruited; mean age (standard deviation [SD]) was 70.5 (8.2) years and mean disease duration (SD) was 5.4 (5.2) years. Raw median PASE was 120.4 (interquartile range [IQR] 68.8-165.7); age-adjusted median PASE was 135.3. Only 9 Veterans (14.3%) were AHA-compliant. There were trends toward negative association between PASE and UPDRS-3 (r = -0.24, p = 0.06) and between PASE and PDQ-8 (r = -0.23, p = 0.08). Sixty-three subjects (84%) completed the EPQ; 27 (42.9%) preferred scheduled exercise, and only 33 (53.2%) reported that they preferred to exercise with others. Common themes of 46 free-text responses included desire to improve PD symptoms (n = 15, 32.6%) and social engagement (n = 12, 26.1%).

Conclusions: Self-reported activity in Veterans with PD is low, with less than 15% of subjects meeting recommended activity targets. Qualitative analysis of barriers and motivators revealed that although many Veterans enjoy the social aspects of group exercise, they may not feel comfortable in general exercise classes aimed at younger participants without chronic illnesses. These data will be useful in designing Veteran- and/or PD-specific interventions to increase activity levels.

Keywords: Lifestyle intervention; Parkinson disease; Physical activity.

MeSH terms

Aged
Exercise / physiology*
Exercise / psychology
Humans
Male
Parkinson Disease / physiopathology*
Parkinson Disease / psychology
Patient Acceptance of Health Care* / psychology
Patient Preference* / psychology
Qualitative Research
United States
United States Department of Veterans Affairs
Veterans* / psychology