Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Ave, Boston, MA 02215, USA.
Phys Ther. 2013 May;93(5):628-36. doi: 10.2522/ptj.20120279. Epub 2013 Jan 3.
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.
The purpose of this study was to identify perceived barriers to exercise in people with PD.
The study had a cross-sectional design.
People who had PD, dwelled in the community, and were at stage 2.4 on the Hoehn and Yahr 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.
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.
The cross-sectional nature of this study limited the ability to make causal inferences.
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.
运动已被证实可减少帕金森病（PD）患者的残疾程度并提高其生活质量。尽管人们已经研究了老年人锻炼的障碍，但对于 PD 等慢性进行性神经疾病患者，锻炼障碍的研究还不够明确。
本研究旨在确定 PD 患者锻炼的感知障碍。
本研究采用横断面设计。
本横断面研究纳入了处于 Hoehn 和 Yahr 分期 2.4 期、居住在社区且能独立生活的 PD 患者（N=260；平均年龄 67.7 岁）。参与者被分为锻炼组（n=164）和非锻炼组（n=96）。参与者使用老年人身体活动和运动能力量表的障碍分量表，自我报告是否存在参加锻炼的特定障碍。采用多变量逻辑回归分析来检验每个障碍对锻炼行为的贡献，并报告比值比。
多变量回归模型保留了 3 个障碍。非锻炼组对低预期锻炼结果（即参与者不期望从锻炼中获益）（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）和害怕跌倒（OR=2.35，95% CI=1.17-4.71）的认同度显著高于锻炼组。
本研究的横断面性质限制了因果推断的能力。
对锻炼的低预期结果、缺乏锻炼时间和害怕跌倒似乎是 PD 患者、可独立活动且居住在社区中、但不经常锻炼的重要感知障碍。对于没有规律锻炼的 PD 患者，这些可能是物理治疗师需要关注的重要问题。干预策略促进 PD 患者坚持锻炼的疗效尚需进一步研究。
