Are Mobile Persons With Parkinson Disease Necessarily More Active?

Abstract

Background and purpose: Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood.

Methods: Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessment (LSA) quantified the extent, frequency, and independence across 5 expanding levels of home and community mobility, producing individual subscores and a total score. Two additional summed scores were used to represent mobility within (Levels 1-3) and beyond (Levels 4-5) neighborhood limits. An accelerometer measured walking activity for 7 days. Regression and correlation analyses evaluated relationships between daily steps and mobility scores. Mann-Whitney U tests secondarily compared differences in mobility scores between the active and sedentary groups.

Results: Walking activity contributed significantly to the summed Level 1-3 score (β = 0.001, P = 0.004) but not to the summed Level 4-5 (β = 0.001, P = 0.33) or total (β = 0.002, P = 0.07) scores. Walking activity was significantly related to Level 1 (ρ = 0.336, P = 0.005), Level 2 (ρ = 0.307, P = 0.010), and Level 3 (ρ = 0.314, P = 0.009) subscores. Only the summed Level 1-3 score (P = 0.030) was significantly different between the active and sedentary groups.

Discussion and conclusions: Persons with PD who demonstrated greater mobility beyond the neighborhood were not necessarily more active; walking activity contributed more so to home and neighborhood mobility. Compared with LSA total score, the Level 1-3 summed score may be a more useful participation-level measure for assessing the impact of changes in walking activity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A349).

Trial registration: ClinicalTrials.gov NCT03517371.

Figure 1.

Model representing individual LSA levels within neighborhood limits (white) and beyond neighborhood limits (gray). The model portrays walking activity as more prevalent in LSA levels 1-3 (A) and passive mobility as more prevalent in LSA levels 4-5 (B).

Figure 2.

Between-group differences in individual level scores (LSA Levels 1-5) based on walking activity (sedentary vs active). The x-axis depicts the five individual life-space levels as follows: Level 1 = inside the home; Level 2 = immediately outside the home (e.g., yard, driveway); Level 3 = neighborhood; Level 4 = town; Level 5 = beyond town. The y-axis depicts the percentage of participants that scored the maximum score for each individual life-space level. *p<.05. The between-group difference in mobility is most pronounced in the neighborhood environment (Level 3).