Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA
Factors associated with ambulatory activity in de novo Parkinson disease
- Published on April 1, 2017
Background: Objective ambulatory activity during daily living has not been characterized for people with Parkinson disease prior to initiation of dopaminergic medication.
Purpose: To characterize ambulatory activity based on average daily step count and examine determinants of step count in non-exercising people with de novo Parkinson disease.
Methods: We analyzed baseline data from a randomized controlled trial, which excluded people performing regular endurance exercise. Of 128 eligible participants (64.3±8.6 years, mean±SD), 113 had complete accelerometer data, which were used to determine daily step count. Multiple linear regression was used to identify factors associated with average daily step count over 10 days. Candidate explanatory variable categories were: 1) demographics/anthropometrics, 2) Parkinson disease characteristics, 3) motor symptom severity, 4) non-motor and behavioral characteristics, 5) comorbidities, and 6) cardiorespiratory fitness.
Results: Average daily step count was 5362±2890 steps/day. Five factors explained 24% of daily step count variability, with higher step count associated with higher cardiorespiratory fitness (10%), no fear/worry of falling (5%), lower motor severity examination score (4%), more recent time since Parkinson disease diagnosis (3%), and the presence of a cardiovascular condition (2%).
Discussion and Conclusions: Daily step count in non-exercising people recruited for this intervention trial with de novo Parkinson disease approached sedentary lifestyle levels. Further study is warranted for elucidating factors explaining ambulatory activity, particularly cardiorespiratory fitness and fear/worry of falling. Clinicians should consider the costs and benefits of exercise and activity behavior interventions immediately after diagnosis of Parkinson disease to attenuate the health consequences of low daily step count.
- Cory Christiansen, PhD, PT 1,2
- Charity Moore, PhD, MSPH 3
- Margaret Schenkman, PhD, PT, FAPTA 1
- Benzi Kluger, MD 4
- Wendy Kohrt, PhD 5
- Anthony Delitto, PhD, PT, FAPTA 6
- Brian Berman, MD 4
- Deborah Hall, MD, PhD 7
- Deborah Josbeno, PhD, PT, NCS, CSCS 6
- Cynthia Poon, PhD 8
- Julie Robichaud, PhD, PT 9
- Toby Wellington, BS 5
- Samay Jain, MD 10
- Cynthia Comella, MD, FAAN 7
- Daniel Corcos, PhD 8
- Ed Melanson, PhD 5,11
Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
Dickson Advanced Analytics, Carolinas HealthCare System, Charlotte, North Carolina, USA
Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Deparment of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois, USA
Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA
Journal of Neurologic Physical Therapy