Factors affecting exercise adherence in patients with Parkinson's disease

Pei-Ling Wu ； Tzu-Ting Huang ； Shey-Lin Wu ； Hsueh-Hou Ho

《中山醫學雜誌》 32卷2期 (2021/12) Pp. 165-175

摘要

Purpose: Motor and non-motor symptoms can appear in the early stages of Parkinson's disease (PD). Regular exercise can reduce the risk of chronic progression and improve these symptoms. However, due to disease symptoms and motor limitations, some PD patients are not motivated or are reluctant to exercise. The purpose of this study was to explore the factors that affect exercise adherence in patients with PD. Methods: This study was based on a cross-sectional design. A total of 49 PD patients were investigated. We divided the participants into the high-exercise group (high exercise adherence ≥ 150 minutes/week) and the low-exercise group (low exercise adherence ＜ 150 minutes/week). The Unified Parkinson's Disease Rating Scale (UPDRS) (Parts II & III), Fatigue Severity Scale (FSS), Pittsburg Sleep Quality Index, Geriatric Depression Scale short form, Hospital Anxiety Scale, and 8-item Parkinson's Disease Questionnaire (PDQ-8) were used to collect data. Logistic regression model was applied to the analysis of the factors that affect exercise adherence. Results: There were significant differences in UPDRS part III (motor skills), FSS (fatigue), and PDQ-8 (Health-Related Quality of Life, HRQOL) results between the high-exercise group and the low-exercise group at baseline (t=-2.349, p=0.023; t=-2.465, p=0.018; t=-2.071, p=0.044). There were also significant differences in the odds of exercise adherence, with the low-exercise group demonstrating lower exercise adherence odds than the high-exercise group, as well as for Levodopa dosage [OR=0.996, 95% CI= (0.992-0.999)], motor skills [(OR=0.693, 95% CI= (0.509-0.944)), and fatigue [OR=0.877, 95% CI=(0.796-0.967)]. Based on UPDRS part II (activity of daily living) scores, the low-exercise group had higher exercise adherence odds than the high-exercise group [OR=1.675, 95% CI= (1.101-2.548)]; (p ＜ 0.05). Conclusions: Levodopa dosage, activity of daily living, motor skills, and fatigue are independent factors for exercise adherence in PD patients. These findings should be considered when developing exercise programs and designing exercise interventions for patients with PD.

關鍵字

Parkinson's disease ； exercise adherence ； motor symptoms ； non-motor symptoms