Pre-active PD: A Therapist Delivered Physical Activity Behavior Change Program for People With Early Stage Parkinson's Disease

Publication Date

2-27-2020

Document Type

Dissertation

Publication Title

Columbia Academia Commons

DOI

10.7916/d8-d59j-tb74

Abstract

PURPOSE Parkinson’s Disease (PD) is a progressive neurodegenerative disorder. Engagement in exercise and physical activity (PA) produce positive effects in people with PD (PwPD), including improvements in motor and cognitive functions. PwPD are 1/3 less active than healthy adults and PA levels decline. Study aim was to evaluate feasibility, acceptability and preliminary efficacy for PA levels, self-efficacy, motivation, and self-perception of performance.

DESIGN: Single arm cohort feasibility study was conducted over 4 months. An occupational therapist (OT) delivered 6 individual (remote or in-person) sessions to provide directed support regarding PA and exercise habits, with check-ins on the other weeks.

METHOD: Sessions utilized workbook-based approach to provide disease-specific education and guide goal setting. Fitbit Charge 2 devices were provided to track progress towards goals and to facilitate therapist coaching. Outcome measures included retention and adherence rates, implementation fidelity, intervention acceptability (TFA questionnaire and PAS-HCCQ), PA levels, time spent in planned versus unplanned activity (Brunel), exercise motivation (BREQ-2), self-efficacy (Norman scale), and perception of and satisfaction with active recreation (mCOPM). Mean differences (post-pre) were calculated for each participant for each measure and then a group mean change with 95% CI, as well as Cohen’s d to calculate effect size.

RESULTS: 61 individuals were contacted. 13 participants with Hoehn and Yahr (H&Y) Stages I-II (mean (SD) age = 61.69 (9.14)) were enrolled. 92% of participants completed all 6 sessions. Intervention delivery had high fidelity and acceptability. Post-intervention improvements seen in self-efficacy (MD = 5.55; 95% CI -1.74-12.74; d = 0.33); identified regulation of motivation (MD = 0.21; 95% CI -0.14-0.55; d = 0.48); planned PA (MD =; 95% CI -0.28-0.98; d = 0.45); and % time in MVPA (MD = 0.79%; 95% CI 0.62-2.38; d = 0.49). Significant improvement in perceptions of performance (MD = 3.09; 95% CI 2.12-4.06; d = 1.63) and satisfaction (MD = .58; 95% CI 1.72-4.06; d = 1.63).

CONCLUSION: Findings suggest Pre-Active PD is feasible and acceptable for PwPD H&Y stage I-II, and may improve exercise levels, self-efficacy, motivation, and planned PA. Future research needed to address limitations and evaluate comparative effectiveness in larger sample size.

Department

Occupational Therapy

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