Objective: To determine which factors at baseline predict responsiveness to a 12 month physical activity intervention in people with Parkinson’s disease (PD).

Background: Previous studies reveal that demographic factors and disease severity influence physical activity levels in people with PD. However, physical activity is typically measured during a single time period [1], [2] or using self-reported physical activity [3]–[5]. Therefore, this study examined which factors predict physical activity over time using objective measures of walking activity in people with PD.

Method: This is a secondary analysis of data from a 12-month, prospective, randomized controlled exercise trial to increase walking activity in people with PD. Participants (N=44) were dichotomized into those whose change in walking activity was above or below the minimally clinically important difference (~800 step/day).  Baseline characteristics including age, disease severity (Movement Disorder Society-Unified Parkinson Disease Rating Scale, Part III), walking capacity (Six Minute Walk Test), physical activity (steps/day), and exercise self-efficacy, were entered into a logistic regression model to predict the likelihood of high walking activity (HWA) or low walking activity (LWA) change at 12 months.

Results: There were 17 individuals in the HWA and 27 in the LWA change group. In the logistic regression analysis, exercise self-efficacy was the only significant predictor of change in walking activity. Age, walking capacity, physical activity and disease severity did not significantly contribute to the model.  Those with higher exercise self-efficacy at baseline increased walking activity levels which exceeded the MCID.

Conclusion: Baseline exercise self-efficacy was a significant predictor of change in walking activity during a 12 month physical activity intervention. Exercise self-efficacy may be an important moderator influencing changes in physical activity over time.  Further studies are needed to determine whether exercise self-efficacy is modifiable and should be a target of intervention.

References: [1] S. Lord, A. Godfrey, B. Galna, D. Mhiripiri, D. Burn, and L. Rochester, “Ambulatory activity in incident Parkinson’s: more than meets the eye?,” J Neurol, vol. 260, no. 12, pp. 2964–2972, Jul. 2013, doi: 10.1007/s00415-013-7037-5. [2] M. L. Dontje et al., “Quantifying daily physical activity and determinants in sedentary patients with Parkinson’s disease,” Parkinsonism Relat. Disord., vol. 19, no. 10, pp. 878–882, Oct. 2013, doi: 10.1016/j.parkreldis.2013.05.014. [3] M. van Nimwegen et al., “Physical inactivity in Parkinson’s disease,” J Neurol, vol. 258, no. 12, pp. 2214–2221, May 2011, doi: 10.1007/s00415-011-6097-7. [4] R. de C. Lana, L. N. de Araujo, F. Cardoso, and F. Rodrigues-de-Paula, “Main determinants of physical activity levels in individuals with Parkinson’s disease,” Arq Neuropsiquiatr, vol. 74, no. 2, pp. 112–116, Feb. 2016, doi: 10.1590/0004-282X20160009. [5] A. Zaman, L. Ellingson, A. Sunken, E. Gibson, and E. L. Stegemöller, “Determinants of exercise behaviour in persons with Parkinson’s disease,” Disabil Rehabil, pp. 1–7, Jul. 2019, doi: 10.1080/09638288.2019.1638975.

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