Abstract
Background Rates of progression of motor symptoms and physical performance show declines between 2% and 7% annually in community samples with Parkinson's disease (PD). However, the effects of ongoing exercise behaviors on progression rates have not been considered. Objective The primary purpose of this prospective, longitudinal study was to examine the annual rates of progression in activity and participation measures over five years in community-based exercisers with PD. Methods A cohort of 55 regular exercisers with idiopathic PD was assessed at baseline and 1, 2, and 5 years. Regular exercise was defined as scores of 4-5 on the Stages for Readiness to Exercise Scale and a self-reported average of at least 60 minutes of exercise/week within six months of each testing session. Unadjusted and adjusted annual progression rates for activity and participation measures were calculated with a standardized equation of change from baseline. A linear mixed model with covariates of age at PD diagnosis and PD subtype was used to determine adjusted change scores. Results Annual progression rates for unadjusted and adjusted variables were similar, and none exceeded 1.7% across time points for this group of exercisers with PD. Older age at PD diagnosis significantly contributed to faster progression of walking and balance functions. A nonlinear trajectory of the PD progression was demonstrated across most activity and participation outcomes. Conclusions Annual progression rates demonstrated by this sample of exercisers were lower than those previously reported for motor decline in general samples with PD. Assessing activity and participation outcomes longitudinally at interim time points was important for understanding the trajectory of change over time. The lower rates of progression in this study warrant further investigation into the long-term effects of exercise in PD.
Highlights
Parkinson’s disease (PD) is the second most common degenerative neurologic disorder worldwide [1]
Baseline descriptive statistics for the total sample, as well as analyzed and excluded cohorts are included in Table 1. ose who were excluded from the analysis had significantly higher scores on the Hoehn and Yahr scale (H&Y) scale, reduced gait endurance, and greater balance impairment compared to the analyzed group. ere were significantly more individuals in the excluded group with postural instability/gait difficulty (PIGD) subtype, which might explain why they had more difficulty with gait and balance
Age at PD diagnosis significantly contributed to the comfortable 10-meter walk test (CWT), 6-minute walk test (6MWT), and Mini-BESTest models, resulting in a greater decline of walking and balance function over time with older age at PD diagnosis (p < 0.05). e PD subtype did not significantly contribute to
Summary
Parkinson’s disease (PD) is the second most common degenerative neurologic disorder worldwide [1]. A. Rates of progression of motor symptoms and physical performance show declines between 2% and 7% annually in community samples with Parkinson’s disease (PD). E primary purpose of this prospective, longitudinal study was to examine the annual rates of progression in activity and participation measures over five years in community-based exercisers with PD. Unadjusted and adjusted annual progression rates for activity and participation measures were calculated with a standardized equation of change from baseline. Annual progression rates for unadjusted and adjusted variables were similar, and none exceeded 1.7% across time points for this group of exercisers with PD. Annual progression rates demonstrated by this sample of exercisers were lower than those previously reported for motor decline in general samples with PD. Assessing activity and participation outcomes longitudinally at interim time points was important for understanding the trajectory of change over time. e lower rates of progression in this study warrant further investigation into the long-term effects of exercise in PD
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