Better Exercise Habits May Be Matter of Class Availability, Study…

Offering more weekly, higher-intensity exercise classes in a broader geographic area can help instill better exercise habits in people with Parkinson’s diseasesuggested a study.

The study, “Associations between exercise classes and self-reported exercise by people with Parkinson’s disease in Parkinson’s Foundation Centers of Excellence”, was published in the magazine Clinical Parkinsonism and Related Disorders.

Growing Evidence Supports Exercise to Help Ease Parkinson’s motor and non-motor symptomsimproving muscle strength, balance, gait speed, cognition, mood, and quality of life for patients.

“According to the findings of the Parkinson’s Outcomes Project (POP), keeping at least 2.5 [hours] of exercise per week is associated with slower declines in quality of life compared with people with [Parkinson’s disease] who don’t exercise regularly,” the researchers noted.

Still, patients often exercise less than the recommended weekly hours. Common reported barriers to regular exercise include disease-specific difficulties, lack of time, fear of falling, and a shortage of convenient venues.

Few studies have looked at ways that might help people with Parkinson’s improve their exercise habits.

Researchers at the Shirley Ryan AbilityLab, a nonprofit physical medicine and rehabilitation research hospital in Chicago, Illinois, investigated associations between exercise class characteristics and self-reported exercise, as well as weekly availability, intensity, the cost and location of classes.

“We sought to identify exercise class-related factors associated with the amount of exercise in [Parkinson’s disease] communities,” they wrote. “We hypothesized that greater availability of exercise classes, more locations, and lower costs would be associated with higher levels of exercise.”

The team used data from the Parkinson’s Outcome Project covering 3,146 patients in 19 participants Centers of Excellence (COE), medical establishments recognized and supported by the Parkinson’s Foundation for their expert and multidisciplinary patient care. Parkinson’s EOC teams include neurologists, movement disorder specialists, physical and occupational therapists, and mental health professionals.

POP, an international patient registry sponsored by the Parkinson Foundation, collects data on patient characteristics, medical history and outcomes to better understand the disease and its course to support research and patient care. Inaugurated in 2009, it currently has the participation of more than 13,000 people in five countries.

The researchers used POP data related to patient-reported hours of moderate exercise, which included brisk walking, dancing, tai chi, yoga, pilates, and pool aerobics, as well as vigorous exercise such as running, swimming, stair climbing, and weight lifting. .

Hours of self-reported light physical activity, which consisted of regular walking, doing housework, or sitting exercises, were also measured. The availability of weekly exercise classes and their cost, intensity, and distance from the class location to the COE were included in the analysis.

Common coexisting medical conditions among participants included back pain (52%), depression (36%), osteoarthritis (35%), high blood pressure (31%), and heart or lung disease (19%).

A higher proportion of exercise classes were found in the community than in an EOC itself, and community classes offered more intense exercise. But the community classes were further from the Centers of Excellence. No significant differences were observed in the proportion of free classes in either of the two places.

Greater availability of weekly classes was positively associated with greater odds of patients engaging in some light physical activity. Increased hours of moderate to vigorous exercise and more light physical activity among those who exercised was also linked to greater class availability.

There was a 1.3% increase in the odds of engaging in any light physical activity for every one-hour increase in weekly class availability. Greater availability was also associated with a 0.4% increase in hours of moderate-vigorous exercise and a 0.8% increase in hours of light physical activity among patients who performed this type of exercise.

These results reflected an average increase of 1.3 minutes of moderate-vigorous exercise and 2.8 minutes of light physical activity for each hour of increase in class availability.

More high-intensity exercise classes were positively associated with better odds of engaging in any light physical activity. Among those who exercised, higher-intensity classes were associated with a nearly 12-minute increase in moderate-vigorous exercise and a nearly 40-minute increase in light physical activity.

“Our findings support the idea that focusing on increased availability and intensity of COE and community exercise classes can benefit the [Parkinson’s disease] community,” the researchers wrote.

Although a higher number of free classes was associated with lower odds of engaging in moderate-to-vigorous exercise or light physical activity, it was associated with a 4.7-minute increase in moderate-to-vigorous exercise among those who exercised.

The odds of doing any exercise, moderate to vigorous or light, were not related to average distance to class at the COE. By comparison, among people who exercised, a 9.1-minute increase in moderate-to-vigorous exercise and a nearly 15-minute increase in light physical activity were associated with distance to a class.

Finally, statistical analysis showed that ease of availability for a weekly exercise class was the most significant factor for more hours of light physical activity and moderate-vigorous exercise to a slightly lesser degree.

“Our results suggest that offering weekly availability of higher-intensity classes with a broader geographic distribution may help bridge the gap between recommended and reported exercise,” the team concluded. “These findings favor the implementation of exercise programs in and near EOCs, particularly in EOCs whose patients have lower-than-average levels of exercise.”