Objective: To evaluate the association between a large number of objectively measured parameters of physical activity in the domestic environment using wearable sensors and Health-Related-Quality of Life (HRQoL) in Parkinson’s disease (PD) patients.

Background: Sedentary lifestyle is associated with worse clinical outcomes in PD, and, conversely, physical activity has a positive influence on disease progression, presumably through multiple mechanisms including a lower rate of dopaminergic neuron degeneration, improved motor commands in the basal ganglia, and better motor control by subcortical and cortical areas. Despite these results, no study has investigated to date the direct association of objective physical activity parameters and HRQoL.

Methods: Forty-three PD patients (14 female; 29 male, mean age: 68y) wore a wearable (3D accelerometer DynaPort Minimod® sensor- McRoberts, The Netherlands) at their lower back for three consecutive days. The following objective parameters (corrected for total wearing time) were then used for statistical analysis: time spent (i) lying, (ii) sitting, (iii) standing, (iv) shuffling, (v) performing any kind of locomotion, (vi) performing sedentary/ light/ moderate/ vigorous activities (metabolic equivalent); (vii) number of steps, (vii) total amount of bouts for each posture, (viii) mean bout length for each posture, (ix) activity-related energy expenditure, (x) total energy expenditure, and (xi) physical activity ratio (ratio between an activity-related energy expenditure and basal metabolic rate). HRQoL was assessed using the sum scores and the Activities-of-Daily-Living (ADL) subscores of the PD Questionnaire-39 (PDQ-39) and the European Quality of Life-5 Dimensions (EQ-5D). Data were analysed using univariate and stepwise multivariate regression analyses.

Results: The total energy expenditure explained the largest percentage of the variation in the sum scores of the PDQ-39 (R2=0.17), the EQ-5D index value (R2=0.12) and the EQ-5D visual analogue score (R2=0.12). Number of steps remained the only significant factor in the ADL subdomain of both the PDQ-39 (R2=0.22) and EQ-5D (R2=0.12).

Conclusions: Our data suggest that the overall energy spent over a day (total energy expenditure and number of steps) explains most of the variance in HRQoL. This indicates that an active lifestyle is a highly relevant predictor of HRQoL in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-between-objectively-measured-physical-activity-and-health-related-quality-of-life-in-people-with-parkinsons-disease/