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Observational Study
. 2017;7(1):193-202.
doi: 10.3233/JPD-160912.

Regular Exercise, Quality of Life, and Mobility in Parkinson's Disease: A Longitudinal Analysis of National Parkinson Foundation Quality Improvement Initiative Data

Miriam R Rafferty  1 , Peter N Schmidt  2 , Sheng T Luo  3 , Kan Li  3 , Connie Marras  4 , Thomas L Davis  5 , Mark Guttman  6 , Fernando Cubillos  2 , Tanya Simuni  7 ; all NPF-QII Investigators
Affiliations
Observational Study

Regular Exercise, Quality of Life, and Mobility in Parkinson's Disease: A Longitudinal Analysis of National Parkinson Foundation Quality Improvement Initiative Data

Miriam R Rafferty et al. J Parkinsons Dis. 2017.

Abstract

Background: Research-based exercise interventions improve health-related quality of life (HRQL) and mobility in people with Parkinson's disease (PD).

Objective: To examine whether exercise habits were associated with changes in HRQL and mobility over two years.

Methods: We identified a cohort of National Parkinson Foundation Quality Improvement Initiative (NPF-QII) participants with three visits. HRQL and mobility were measured with the Parkinson's Disease Questionnaire (PDQ-39) and Timed Up and Go (TUG). We compared self-reported regular exercisers (≥2.5 hours/week) with people who did not exercise 2.5 hours/week. Then we quantified changes in HRQL and mobility associated with 30-minute increases in exercise, across PD severity, using mixed effects regression models.

Results: Participants with three observational study visits (n = 3408) were younger, with milder PD, than participants with fewer visits. After 2 years, consistent exercisers and people who started to exercise regularly after their baseline visit had smaller declines in HRQL and mobility than non-exercisers (p < 0.05). Non-exercisers worsened by 1.37 points on the PDQ-39 and a 0.47 seconds on the TUG per year. Increasing exercise by 30 minutes/week was associated with slower declines in HRQL (-0.16 points) and mobility (-0.04 sec). The benefit of exercise on HRQL was greater in advanced PD (-0.41 points) than mild PD (-0.14 points; p < 0.02).

Conclusions: Consistently exercising and starting regular exercise after baseline were associated with small but significant positive effects on HRQL and mobility changes over two years. The greater association of exercise with HRQL in advanced PD supports improving encouragement and facilitation of exercise in advanced PD.

Keywords: Parkinson disease; exercise; mobility limitations; quality of life; rehabilitation.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURE FOR PRESENT STUDY

All authors receive salary, research support, and/or honoraria from the National Parkinson Foundation.

Figures

Fig. 1
Fig. 1
Health-related quality of life and mobility over two years. Absolute (A and B), risk-adjusted (C and D), and risk-adjusted change from baseline (E and F) health-related quality of life (A, C, and E) and mobility (B, D, and F) by exercise classification across three visits, or approximately 2 years. Risk-adjusted values in C–F are controlled for age, sex, disease duration, disease severity, and comorbidities. Analyses are performed only on risk-adjusted change from baseline (E–F) due to non-equivalence at baseline for absolute and risk-adjusted HRQL and mobility (A–D). *indicates Holm-adjusted p < 0.05. **indicates Holm-adjusted p < 0.01. Abbreviations: HRQL, Health-related quality of life; hrs, hours; PDQ-39, Parkinson’s disease questionnaire.
See this image and copyright information in PMC

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