Ahern Leanne, Curtin Catriona, Timmons Suzanne, Lamb Sarah E, McCullagh Ruth
Discipline of Physiotherapy, School of Clinical Therapies, University College Cork, T12 X70A Cork, Ireland.
Centre for Gerontology and Rehabilitation, School of Medicine, College of Medicine and Health, University College Cork, T12 FN70 Cork, Ireland.
Geriatrics (Basel). 2024 Jul 11;9(4):92. doi: 10.3390/geriatrics9040092.
The benefits of exercise have been widely explored among people with Parkinson's (PwP). Exercise can improve non-motor (fatigue, pain, sleep, etc.) and motor features (balance, muscle strength, gait speed, etc.), maintain function, as well as prevent disease progression. Although the benefits are well known, PwP continue to show difficulty adhering to physical activity and exercise. This study aims to explore motivation to exercise, support, and self-management needs among people with Parkinson's, their family members, and physiotherapists. Purposeful and maximum-variation sampling methods (age, sex, geographical setting, and disease severity) were employed. PwP and family members were recruited through physiotherapy services and local support groups. Twelve semi-structured interviews with PwP and two group interviews, one with family members ( = 4) and one with physiotherapists ( = 5), were conducted. Interview guides were informed by patient-public input and a recent systematic review. Interviews were recorded, transcribed, and analysed using thematic analysis informed by the Grounded Theory methodology. Four common themes emerged: (1) The value of an intrinsic connection with exercise, for which there are challenges. A greater connection to exercise led to long-term adherence. (2) Adapting exercise to the needs and preferences of a person is essential. Preferred exercises and environments were mixed, with differences emerging between sexes. (3) Physiotherapists' aim to only maintain physical function led to frustration. Limited self-management opportunities, stigma, and dehumanisation were discussed. (4) Non-motor symptoms, stigma, fear, and determination as well as apathy, pain, and low mood were discussed. Exercise provided physical, emotional, and social rewards. Supports are necessary; however, challenges arise when PwP's motivations are mismatched to family members' and physiotherapists' goals. Co-created goals, tailored to their preferences, and exercise plans with supported self-management are recommended.
运动对帕金森病患者（PwP）的益处已得到广泛研究。运动可以改善非运动症状（疲劳、疼痛、睡眠等）和运动功能（平衡、肌肉力量、步态速度等），维持身体功能，还能预防疾病进展。尽管这些益处广为人知，但帕金森病患者在坚持体育活动和锻炼方面仍存在困难。本研究旨在探讨帕金森病患者及其家庭成员和物理治疗师的运动动机、支持需求和自我管理需求。采用了有目的和最大差异抽样方法（年龄、性别、地理环境和疾病严重程度）。通过物理治疗服务和当地支持小组招募了帕金森病患者及其家庭成员。对帕金森病患者进行了12次半结构化访谈，对家庭成员（n = 4）和物理治疗师（n = 5）分别进行了1次小组访谈。访谈指南参考了患者公众的意见和近期的系统评价。访谈进行了录音、转录，并采用基于扎根理论方法的主题分析进行分析。出现了四个共同主题：（1）与运动建立内在联系的价值，但存在挑战。与运动的更强联系会带来长期坚持。（2）根据个人需求和偏好调整运动至关重要。偏好的运动和环境各不相同，性别之间存在差异。（3）物理治疗师仅旨在维持身体功能的目标导致了挫败感。讨论了自我管理机会有限、污名化和非人性化问题。（4）讨论了非运动症状、污名化、恐惧和决心以及冷漠、疼痛和情绪低落。运动带来身体、情感和社交回报。支持是必要的；然而，当帕金森病患者的动机与家庭成员和物理治疗师的目标不匹配时，就会出现挑战。建议共同制定符合他们偏好的目标以及有支持性自我管理的运动计划。
