SAN DIEGO—Initiating regular exercise outside of structured interventions is associated with a slower decline in quality of life in patients with Parkinson’s disease, according to research presented at the 19th International Congress of Parkinson’s Disease and Movement Disorders.
Studies have shown that short-term interventions—including tailored Parkinson’s disease exercise programs, progressive resistance training, treadmill training, tai chi, and tango—can improve quality of life. To examine whether patients with Parkinson’s disease who change their regular exercise behavior outside of structured exercise interventions can slow long-term decline in Parkinson’s disease-related quality of life, Miriam R. Rafferty, DPT, NCS, of the Graduate Program in Neuroscience at University of Illinois at Chicago, and her research colleagues analyzed a dataset of 2,940 patients from 20 sites affiliated with the National Parkinson Foundation Quality Improvement Initiative. The patients were assessed using Parkinson’s Disease Questionnaire-39 (PDQ-39) at baseline and at one-year and two-year follow-up appointments. Those who were classified as nonexercisers at baseline (ie, they did not report exercising at least 2.5 hours per week as recommended by the Centers for Disease Control and Prevention Physical Activity Guidelines) and began to exercise after their initial visit had significantly less worsening of PDQ-39 than nonexercisers.
Patients who exercised regularly at baseline and during the following two years demonstrated a 2.3 point increase (worsening) in PDQ-39 summary index from a baseline average of 18. Patients who did not report regular exercise at any visit worsened by 4.1 points from a baseline of 27. Patients who started regular exercise after the first visit had significantly less decline in quality of life over two years (1.4), compared with those who started regular exercise after the second visit (3.2).
Researchers also looked at a subset of 1,048 patients with moderately impaired quality of life (ie, PDQ-39 of 15 to 30) who all began the study as nonexercisers. The subset analysis revealed that patients who began to exercise after their initial visit had significantly less worsening of PDQ-39 than nonexercisers (1.4 vs 4.1).
In the moderately impaired subset, “beginning to exercise after baseline visit was associated with worsening of PDQ-39 by only 1.3 over two years. This is less than the change required for patients to feel ‘a little worse’ (1.6),” the researchers said. “Not exercising at all is associated with a [worsening] in PDQ-39 of 6.2 over two years, which is substantially greater than the [standard error of measurement].”
In addition, among patients in the moderately impaired subset who began exercising after the first visit, 52% showed improved health-related quality of life over baseline. Among those who began exercising after the second visit, 41% had improved quality of life over baseline.
“This study makes clear that everyone with Parkinson’s [disease] should be exercising,” said Michael Okun, MD, Professor of Neurology at the University of Florida Center for Movement Disorders and Neurorestoration in Gainesville. “This longitudinal study of patients selected without exclusions shows that patients suffer from delaying starting their exercise program. It doesn’t seem to matter what they do, they benefit from just getting up and out and from moving.”