Impact of a community based exercise programme for people with Parkinson disease

Abstract

Objective: To develop and evaluate the impact of an 8-week community based exercise programme delivered by a community fitness facilitator upon performance and self-report measures in participants with Parkinson disease. Design: Prospective, single group pre/post test Setting: Older Adults Community Centre in Northwestern Ontario Participants: Eleven participants (6 men, 5 women; mean age, 70.45 ± 1.98; mean length of disease, 3.27 years) with Idiopathic Parkinson disease, Hoehn & Yahr stages 1.0 to 2.5 and stable medication use. Intervention: An 8 week exercise programme, developed by physiotherapists and delivered in the community by a community fitness facilitator trained through a competency based approach. Outcome measures: The Unified Parkinson Disease Rating Scale motor subsection score (UPDRSm), the Berg Balance Scale (BBS), the Timed Up and Go Test (TUG), the Parkinson Disease Questionnaire-39 (PDQ-39), and the Activities-specific Balance Confidence Scale (ABC scale) were assessed at baseline and after the 8 week exercise programme. Attendance rates and the occurrence of any adverse events were recorded throughout the 8-week exercise programme by the fitness facilitator. Results: Analysis of the outcome measures resulted in the removal of one participant outlier. Subsequent analysis of the remaining 10 participants resulted in a statistically significant decrease in the UPDRSm from baseline to 8 weeks (7.70, p = 0.001), and a statistically significant increase in TUG scores (2.03, p - 0.005). Although no statistical significance was demonstrated in the other outcome measures, significant effect size was demonstrated for all outcome measures. All eleven participants completed the study with an adherence rate o f 90.8% attendance in the exercise programme. There were no adverse events reported. Conclusion; A community based exercise programme, developed by physiotherapists and delivered by a community fitness facilitator, can be provided safely to a group of people with Parkinson Disease. The exercise programme also appears to have demonstrated sufficient intensity to elicit changes in motor function, as measured by the UPDRSm, and there is potential for changes in all outcome measures with a larger sample population. It is hoped that this unique process o f identifying and addressing the needs o f a particular client population in Northwestern Ontario will help to facilitate the ongoing development of physiotherapy initiatives which address the changing reality of healthcare.