Category: Neurodegenerative Disease (e.g. MS, Parkinson's disease); Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To investigate which intervention leads to greater increase in physical activity in persons with Parkinson's disease (PD) over three months.
Randomized controlled clinical trial in a 2x2 factorial design. Participants were randomized into one of four groups for six months. Participants are assessed at baseline, 3 months, 6 months and 9 months.
Outpatient clinics at a Midwestern free-standing rehabilitation facility and an acute care facility.
Participants (or Animals, Specimens, Cadavers) :
Participants are from a convenience sample of 17 outpatients with PD. Demographics included: mean age 67.5 years (SD=10.6); 65% male, 94% white; and 94% college graduate. Most participants were either working full-time (41%) or retired (41%). The average diagnosis time was about 4 years.
Participants were randomized to one of four groups: control group accessing a PD educational website offering several topics except physical activity (n=3); a motivational interviewing (MI) group using person-centered methods to enhance intrinsic motivation (n=5); a group that used a web-based app to track goals (n=5); or a group with a combination of using both MI and the web-based tracking app (n=4). Randomization was stratified based on age and Hoehn-Yahr score ≤3.
Main Outcome Measure(s) :
Objectively measured moderate-to-vigorous physical activity (MVPA) by accelerometers (ActiGraph GT3X) and self-reported physical activity participation assessed by the Physical Activity Scale for Individuals with Physical Disabilities.
Over the 3-month period, the MI group on average increased MVPA by 35.8 minutes/week (SD=75.8), the MI plus App group increased MVPA by 3.3 minutes/week (SD=18.6), the control group increased MVPA by 2.4 minutes/week (SD=17.8), while the Web-based app group decreased MVPA by 5.3 minutes/week (SD=51.4). Participants reporting moderate exercise increased from 22% to 47% over the 3 months. Those reporting never participating in moderate exercise decreased from 69% to 53%. The most popular form of physical activity was walking.
Participants receiving motivational interviewing increased their MVPA on a weekly basis greater than the educational control group. Adding the web-based tracking app had minimal benefit.
Linda Ehrlich-Jones– Assistant Director, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois
Edeth Engel– Project Coordinator, Shirley Ryan AbilityLab, Chicago, Illinois
Jing Song– Research Consultant, Northwestern University, Worthington, Ohio
Kayleigh Mann– Research Assistant, Shirley Ryan AbilityLab, Chicago, Illinois
Allison Greene– MD/MPH student, University of Vermont, Chicago, Illinois
Jessica Presperin Pedersen– Assistant Professor Research OT, Shirley Ryan AbilityLab, Chicago, Illinois
Jungwha Lee– Associate Professor, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Danny Bega– Assistant Professor of Neurology, Northwestern University, Chicago, Illinois