Allen Natalie E, Song Jooeun, Paul Serene S, Sherrington Catherine, Murray Susan M, O'Rourke Sandra D, Lord Stephen R, Fung Victor S C, Close Jacqueline C T, Howard Kirsten, Canning Colleen G
Clinical and Rehabilitation Sciences Research Group Faculty of Health Sciences The University of Sydney Sydney Australia.
The George Institute for Global Health Sydney Medical School The University of Sydney Sydney Australia.
Mov Disord Clin Pract. 2015 Jun 30;2(4):395-401. doi: 10.1002/mdc3.12208. eCollection 2015 Dec.
Long-term benefits of exercise for people with Parkinson's disease (PD) require regular and sustained participation. This study aimed to investigate predictors of adherence to a minimally supervised exercise program designed to reduce falls in people with PD.
People with idiopathic PD who participated in the exercise arm of a randomized, controlled trial were included. Exercises were prescribed three times per week for 6 months. Adherence was defined as the percentage of prescribed sessions participants reported as having undertaken. Potential predictors of adherence included baseline measures of demographic variables, disease severity and duration, falls and fear of falling, pain, self-reported health and quality of life, cognition, physical activity levels, freezing of gait, functional mobility and balance, and knee extensor strength.
The 108 participants included undertook a mean of 72% (standard deviation: 38%) of prescribed sessions. Participants had higher levels of adherence if they had shorter disease duration, less bodily pain, and better self-reported health and quality of life. A multivariate model (including disease duration, severity of bodily pain, self-reported physical well-being, the Frontal Assessment Battery, the Short Physical Performance Battery, and maximum walking time) explained 9% of the variance in exercise adherence, with shorter disease duration and less pain the strongest predictors (both predictors standardized β = -0.2; = 0.04).
Disease duration and pain are likely to negatively influence exercise participation in people with PD. Given that most of the variance in adherence is unexplained, further work is required to determine other predictors of adherence to long-term exercise programs.
运动对帕金森病（PD）患者的长期益处需要定期且持续的参与。本研究旨在调查参与一项旨在减少PD患者跌倒的最低限度监督运动计划的依从性预测因素。
纳入参与一项随机对照试验运动组的特发性PD患者。运动处方为每周三次，共6个月。依从性定义为参与者报告完成的规定疗程的百分比。依从性的潜在预测因素包括人口统计学变量、疾病严重程度和病程、跌倒及跌倒恐惧、疼痛、自我报告的健康状况和生活质量、认知、身体活动水平、步态冻结、功能活动能力和平衡，以及膝关节伸肌力量的基线测量值。
108名参与者完成的规定疗程平均为72%（标准差：38%）。病程较短、身体疼痛较少、自我报告的健康状况和生活质量较好的参与者依从性较高。一个多变量模型（包括病程、身体疼痛严重程度、自我报告的身体健康状况、额叶评估量表、简短体能表现量表和最大步行时间）解释了运动依从性差异的9%，病程较短和疼痛较少是最强的预测因素（两个预测因素的标准化β = -0.2；P = 0.04）。
病程和疼痛可能对PD患者的运动参与产生负面影响。鉴于大部分依从性差异无法解释，需要进一步开展工作以确定长期运动计划依从性的其他预测因素。
