39 CAN BEHAVIOURAL CHANGE INTERVENTIONS IMPROVE SELF-EFFICACY AND EXERCISE ADHERENCE AMONG PEOPLE WITH PARKINSON’S? A SYSTEMATIC REVIEW

Abstract

Abstract Background People with Parkinson’s (PwP) lead sedentary lifestyles compared to healthy peers. Personal influences including low self-efficacy and poor outcome expectation appear to predict exercise adherence more accurately than disease severity. The purpose of this review is to identify successful behavioural-change interventions that promote self-efficacy and exercise adherence among PwP. Methods Databases including EBSCO, Medline, CINAHL, Web of Science, PubMed, Embase, Scopus, Google Scholar and Cochrane Library were searched from inception to 2020. Interventional studies including a behavioural-change intervention were included. Title, abstract and full-text screening was conducted by two independent reviewers. The Cochrane Risk of Bias Tool and Robins-I were used to assess the Risk of Bias. Data was extracted by two independent reviewers. The outcomes of interest were self-efficacy, quality of life, physical function, and exercise adherence. A narrative synthesis was completed and mapped to the Theoretical Domains Framework, to produce practice-orientated outcomes. Results Seventeen studies (n=1319) were included. Risk of bias was generally moderate. A multicomponent behavioural-change intervention encompassing education, behavioural strategies and support groups appeared to improve quality of life, physical function, and exercise adherence in PwP. No intervention improved self-efficacy. Self-monitoring, goal setting, social supports, feedback, self-managements skills and action planning improved long-term adherence. Conclusion No intervention changed self-efficacy. However, it appears that a multicomponent intervention is essential to improve exercise adherence. Trials directly comparing different intervention types and adequate follow-up periods are limited, preventing a conclusive finding of the most effective behavioural-change intervention to promote exercise adherence among PwP.