Are Mobile Persons With Parkinson Disease Necessarily More Active?

Abstract

Background and purpose: Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood.

Methods: Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessment (LSA) quantified the extent, frequency, and independence across 5 expanding levels of home and community mobility, producing individual subscores and a total score. Two additional summed scores were used to represent mobility within (Levels 1-3) and beyond (Levels 4-5) neighborhood limits. An accelerometer measured walking activity for 7 days. Regression and correlation analyses evaluated relationships between daily steps and mobility scores. Mann-Whitney U tests secondarily compared differences in mobility scores between the active and sedentary groups.

Results: Walking activity contributed significantly to the summed Level 1-3 score (β = 0.001, P = 0.004) but not to the summed Level 4-5 (β = 0.001, P = 0.33) or total (β = 0.002, P = 0.07) scores. Walking activity was significantly related to Level 1 (ρ = 0.336, P = 0.005), Level 2 (ρ = 0.307, P = 0.010), and Level 3 (ρ = 0.314, P = 0.009) subscores. Only the summed Level 1-3 score (P = 0.030) was significantly different between the active and sedentary groups.

Discussion and conclusions: Persons with PD who demonstrated greater mobility beyond the neighborhood were not necessarily more active; walking activity contributed more so to home and neighborhood mobility. Compared with LSA total score, the Level 1-3 summed score may be a more useful participation-level measure for assessing the impact of changes in walking activity.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A349).

Trial registration: ClinicalTrials.gov NCT03517371.

Conflict of interest statement

The authors declare no conflict of interest.

Copyright © 2021 Academy of Neurologic Physical Therapy, APTA.

Figures

Figure 1.

Model representing individual LSA levels within neighborhood limits (white) and beyond neighborhood limits (gray). The model portrays walking activity as more prevalent in LSA levels 1-3 (A) and passive mobility as more prevalent in LSA levels 4-5 (B).

Figure 2.

Between-group differences in individual level scores (LSA Levels 1-5) based on walking activity (sedentary vs active). The x-axis depicts the five individual life-space levels as follows: Level 1 = inside the home; Level 2 = immediately outside the home (e.g., yard, driveway); Level 3 = neighborhood; Level 4 = town; Level 5 = beyond town. The y-axis depicts the percentage of participants that scored the maximum score for each individual life-space level. *p<.05. the between-group difference in mobility is most pronounced neighborhood environment>