Miller Stephanie A, Mayol Mindy, Moore Elizabeth S, Heron Audra, Nicholos Victoria, Ragano Brian
University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA.
University of Indianapolis, Interprofessional Health and Aging Studies, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA.
Parkinsons Dis. 2019 Sep 22;2019:5679187. doi: 10.1155/2019/5679187. eCollection 2019.
Rates of progression of motor symptoms and physical performance show declines between 2% and 7% annually in community samples with Parkinson's disease (PD). However, the effects of ongoing exercise behaviors on progression rates have not been considered.
The primary purpose of this prospective, longitudinal study was to examine the annual rates of progression in activity and participation measures over five years in community-based exercisers with PD.
A cohort of 55 regular exercisers with idiopathic PD was assessed at baseline and 1, 2, and 5 years. Regular exercise was defined as scores of 4-5 on the Stages for Readiness to Exercise Scale and a self-reported average of at least 60 minutes of exercise/week within six months of each testing session. Unadjusted and adjusted annual progression rates for activity and participation measures were calculated with a standardized equation of change from baseline. A linear mixed model with covariates of age at PD diagnosis and PD subtype was used to determine adjusted change scores.
Annual progression rates for unadjusted and adjusted variables were similar, and none exceeded 1.7% across time points for this group of exercisers with PD. Older age at PD diagnosis significantly contributed to faster progression of walking and balance functions. A nonlinear trajectory of the PD progression was demonstrated across most activity and participation outcomes.
Annual progression rates demonstrated by this sample of exercisers were lower than those previously reported for motor decline in general samples with PD. Assessing activity and participation outcomes longitudinally at interim time points was important for understanding the trajectory of change over time. The lower rates of progression in this study warrant further investigation into the long-term effects of exercise in PD.
在帕金森病（PD）社区样本中，运动症状和身体机能的进展率每年下降2%至7%。然而，持续运动行为对进展率的影响尚未得到考虑。
这项前瞻性纵向研究的主要目的是检查以社区为基础的PD运动者在五年内活动和参与度指标的年进展率。
对55名特发性PD的定期运动者队列在基线、1年、2年和5年时进行评估。定期运动的定义是在运动准备阶段量表上得分为4-5分，且在每次测试前六个月内自我报告平均每周至少锻炼60分钟。活动和参与度指标的未调整和调整后的年进展率通过与基线的标准化变化方程计算得出。使用包含PD诊断时年龄和PD亚型协变量的线性混合模型来确定调整后的变化分数。
未调整和调整后变量的年进展率相似，对于这组PD运动者，各时间点均未超过1.7%。PD诊断时年龄较大显著导致步行和平衡功能进展更快。在大多数活动和参与度结果中显示出PD进展的非线性轨迹。
该运动者样本显示的年进展率低于先前报道的一般PD样本中的运动衰退率。在中间时间点纵向评估活动和参与度结果对于理解随时间的变化轨迹很重要。本研究中较低的进展率值得进一步研究运动对PD的长期影响。
