Objective: To understand exercise habits, motivators, and barriers to exercise among PD patients.

Background: Despite a large body of literature demonstrating the benefits of physical activity in PD, many patients remain sedentary. Low-outcome expectation, fear of falling, and lack of time have been identified as significant barriers to exercise, but more detailed data is lacking.

Methods: An optional survey of multiple-choice or Likert-scale-based questions regarding exercise habits and preferences was presented to all patients with IPD seen at the Northwestern Movement Disorders Clinic upon check-in.

Results: 150 surveys were collected over 2 months. Participants were captured at all stages of disease (33% with PD for <3 years,17% with PD for > 10 years). 52% of responders reported exercising >3 hours per week (exercisers) and 48% reported exercising ≤3 hours per week (low exercisers) or not at all (non-exercisers). 73% reported that they believe scientific evidence shows that exercise slows the progression of PD symptoms, 22% were unsure, and 5% did not believe. The majority of responders believed that exercise can improve speed (69% exercisers, 60% low/non-exercisers) and balance/fall risk (64% exercisers, 54% low/non-exercisers), but few felt that it could improve tremor (27% exercisers, 35% low/non-exercisers). 19% of exercisers and 25% of low/non-exercisers perceived fear of falling as a barrier to exercise. Only 4% of exercisers and 7% of low/non-exercisers perceived lack of time as a barrier to exercise. For the low/non-exercisers, additional barriers included having no one to exercise with or motivate them (31%) and daytime fatigue (32%). For the exercisers, additional major barriers included history of falls (24%) and believing that their PD symptoms interfered (19%). The exercise characteristics that were most likely to motivate participation were:1) having another person to exercise with and 2) exercising in a group or with an instructor/trainer.

Conclusions: Only half of PD patients in this practice were regular exercisers. Beliefs about the benefits of exercise in PD varied, suggesting a need for better education in this regard. Fear of falling and history of falls was a common barrier to exercise; lack of time was not. For low/non-exercisers, lacking someone to exercise with or to motivate them was a significant barrier. Future exercise recommendations in PD should take these motivators and barriers into consideration.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motivators-and-barriers-to-participation-in-exercise-in-parkinsons-disease/