Barriers to Exercise in People With Parkinson Disease
Barriers to Exercise in People With Parkinson Disease
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DOI：
10.2522/ptj.20120279
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发表时间：
2013-05-01
期刊：
影响因子：
3.2
通讯作者：
Dibble, Leland E.
中科院分区：
文献类型：
--
作者：
Ellis, Terry;Boudreau, Jennifer K.;Dibble, Leland E.
背景众所周知，运动可以减少帕金森病（PD）患者的残疾并提高生活质量。虽然已经在老年人中研究了运动障碍，但患有慢性进行性神经系统疾病（如PD）的人的障碍尚未得到很好的定义。本研究的目的是识别PD. Design患者运动的感知障碍。本研究采用横断面设计。居住在社区的PD患者，Hoehn和Yalu量表评分为2.4级，参与了这项横断面研究（N=260;平均年龄=67.7岁）。参与者被分为运动组（n=164）和非运动组（n=96）。参与者自我管理的障碍分量表的身体素质和锻炼活动水平的老年人规模，赞同或否认具体的障碍，锻炼参与。采用多因素Logistic回归分析各因素对运动行为的影响，并计算优势比。在多元回归模型中保留了三个障碍。不锻炼组有显著更大的几率赞同低结果期望（即参与者不期望从运动中获益）（比值比[OR]=3.93，95%置信区间[CI]=2.08-7.42），缺乏时间（OR=3.36，95%CI =1.55-7.29），害怕跌倒（OR=2.35，95%CI =1.17-4.71）。这项研究的横截面性质限制了因果推理的能力。对运动的结果期望低、缺乏运动时间和害怕摔倒似乎是PD患者、非卧床患者和居住在社区的患者参与运动的重要感知障碍。这些可能是物理治疗师针对PD患者和不定期锻炼的重要问题。干预策略的有效性，以促进运动坚持与PD的人需要进一步调查。
Background. Exercise is known to reduce disability and improve quality of life in people with Parkinson disease (PD). Although barriers to exercise have been studied in older adults, barriers in people with chronic progressive neurological diseases, such as PD, are not well defined.Objective. The purpose of this study was to identify perceived barriers to exercise in people with PD.Design. The study had a cross-sectional design.Methods. People who had PD, dwelled in the community, and were at stage 2.4 on the Hoehn and Yalu- scale participated in this cross-sectional study (N=260; mean age=67.7 years). Participants were divided into an exercise group (n=164) and a nonexercise group (n=96). Participants self-administered the barriers subscale of the Physical Fitness and Exercise Activity Levels of Older Adults Scale, endorsing or denying specific barriers to exercise participation. Multivariate logistic regression analysis was used to examine the contribution of each barrier to exercise behavior, and odds ratios were reported.Results. Three barriers were retained in the multivariate regression model. The nonexercise group had significantly greater odds of endorsing low outcome expectation (ie, the participants did not expect to derive benefit from exercise) (odds ratio [OR]=3.93, 95% confidence interval [CI]=2.08-7.42), lack of time (OR=3.36, 95% CI=1.55-7.29), and fear of falling (OR=2.35, 95% CI=1.17-4.71) than the exercise group.Limitations. The cross-sectional nature of this study limited the ability to make causal inferences.Conclusions. Low outcome expectation from exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise in people who have PD, are ambulatory, and dwell in the community. These may be important issues for physical therapists to target in people who have PD and do not exercise regularly. The efficacy of intervention strategies to facilitate exercise adherence in people with PD requires further investigation.