Processes to Increase Exercise Adherence and Sustainment in Parkinson's Disease

A goal of the National Parkinson Foundation Parkinson Outcome Project (NPF-POP) is to improve long-term patient outcomes with Parkinson’s disease, and exercise is a best practice that is strongly encouraged.1 We previously completed longitudinal analyses using the NPF-POP dataset showing that people who increase their exercise soon after enrollment in the registry had slower declines in physical function and quality of life.2 While over 50% of the people enrolled in the NPF-POP report exercising at least 150 minutes per week in the earlier stages of Parkinson’s disease (PD), this number drops as the disease progresses (Figure 1).2,3 Patient-reported barriers to exercise include PD symptoms, fear of falling, lack of information, inconvenient locations, time constraints, and low expectations of improvement.4-6 A survey led by study team member, Dr. Bega, suggests that motivators to exercise adherence could include exercise buddies, trainers, classes, and physician encouragement.7 Thus far, the data on barriers and facilitators to exercise have been collected using cross-sectional designs and static surveys comparing exercisers to non-exercisers at one time point. These static study designs do not allow for exploration of the processes governing changes in exercise. In other words, we still do not know what helps non-exercisers start to exercise, nor do we know the processes that lead to decreases in exercise in people who previously exercised. Exploring these dynamic processes is an essential foundation for the development of interventions that can be used to help people increase their exercise participation if needed, or to intervene when they are at risk of decreasing their exercise.