Community-Based Cycling Program Shows Positive Impact on Symptom Management in Parkinson Disease

A community-based exercise program was associated with positive responses among patients with Parkinson disease (PD) in regards to symptom management and overall enjoyment, according to study findings published in Complementary Therapies in Medicine.

Exercise has emerged as an important component of disease management in people with PD (PwP) over the past decade, as preliminary studies have shown that high-intensity aerobic exercise provides neuroprotective effects and may cause neuroplastic changes in the central nervous system.

However, researchers note that current evidence indicates that PwP are not meeting weekly benchmarks of aerobic exercise, with only 27% of PwP achieving the 150 minutes of moderate-vigorous physical activity per week recommended by the Parkinson’s Foundation and the American College of Sports Medicine.

“The low level of physical activity may be in part due to the barriers to exercise in PwP, which include low outcome expectations, lack of time, fear of falling, and lack of motivation,” the study authors wrote. “Community-based exercise classes may overcome barriers and encourage exercise compliance by fostering meaningful social interactions, providing external motivation via an exercise instructor, and being conveniently located close to one’s home.”

They conducted a cross-sectional survey analysis of PwP who were part of Pedaling for Parkinson’s (PFP), a community-based cycling program, to explore personal beliefs, motivators, and barriers to participation over a 12-month period. Participants were recruited from 5 community-based facilities (2 in northern Washington and 3 in central Colorado) with established PFP programs.

Cycling classes were held 3 times per week over 45 to 60 minutes (including a 5-10 minute warm-up and cool-down), with the target pedaling cadence identified to be between 80 and 90 revolutions per minute, and an aerobic intensity between 60% and 80% of their age-estimated heart rate maximum or a rating of perceived exertion (RPE) between 4 and 7 on a 10-point RPE scale.

The survey administered at the end of the 12-month observational period was designed to capture the attitudes and beliefs of those participating in a PFP program, with survey responses rated on a 5-point Likert scale (1-5; higher number representing a more positive response) assessing the subdomains of Personal Beliefs and Knowledge, Health and Disability, Program, and Fitness Environment. The relationship between demographic variables and survey responses was also explored.

“Insight into exercise attitudes and beliefs in successful community programs may assist in tailoring future programs for neurological populations,” noted the researchers.

A total of 40 PwP completed the survey. Mean (SD) attendance from the observed cohort was 75.6 (26.4) sessions over the 12-month period.

Subdomain scores showed that PwP who attended a PFP program enjoyed the class, felt that their PD symptoms benefited from exercise, and were motivated to exercise by their PD diagnosis. The mean (SD) scores for the 4 subdomains were as follows:

• Personal Beliefs and Knowledge, 4.37 (0.41)
• Health and Disability, 4.25 (0.65)
• Program, 4.11 (0.53)
• Fitness Environment, 4.35 (0.44)

No significant correlations were observed between survey subdomains and demographic variables (age, years of education, years since diagnosis, years attending the PFP program, and disease severity; P > .05) or subdomains and exercise behavior (cadence, attendance, and heart rate).

The Fitness Environment subdomain revealed that cost, parking and transportation, proximity to residence, and ease of gym navigation were important factors for participants regarding adherence to community-based programs.

“With the growing body of PD literature supporting the role of exercise in potentially altering the disease trajectory, it is critical that communities adopt and implement exercise programs that meet the needs of PwP and facilitate compliance,” the study authors concluded.

Reference

Rosenfeldt AB, Koop MM, Penko AL, Zimmerman E, Miller DM, Alberts JL. Components of a successful community-based exercise program for individuals with Parkinson’s disease: Results from a participant survey. Complement Ther Med. Published online August 5, 2022. doi:10.1016/j.ctim.2022.102867