Search

Aim: To compare self-reported pedometer steps with accelerometer steps under free-living conditions in individuals with Parkinson's disease (PD) or osteoporosis (OP). Methods: Seventy-three individuals with PD and 71 individuals with OP wore a pedometer (Yamax LS2000) and an accelerometer (ActiGraph GT1M/GT3X+) simultaneously for one week. Results: Fifty-one individuals with PD (72.6 ± 5.3 years) and 61 with OP (75.6 ± 5.3 years) provided simultaneously recorded data for 3-7 consecutive days. Pedometer steps were significantly lower than accelerometer steps in the PD group (p = .002) but not in the OP group (p = .956). Bland-Altman plots demonstrated wide limits of agreement between the instruments in both PD (range = 6,911 steps) and OP (range = 6,794 steps). Conclusion: These results suggest that the ActiGraph GT1M/GT3X+ should be preferred over the Yamax LS2000 for the assessment of steps in both research and clinical evaluations, particularly in individuals with PD or altered gait. [ABSTRACT FROM AUTHOR]

Background. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a clinical balance test comprising 14 items assumed to reflect the unidimensional construct "dynamic balance." Objective. The study objective was to examine the dimensionality of the test and the properties of each item and their interrelationships in elderly people with mild to moderate Parkinson disease (PD). Design. This was a cross-sectional study in a laboratory setting. Methods. A total of 112 participants (mean age=73 years) with idiopathic PD (Hoehn and Yahr stages 1-3) were assessed by physical therapists. Local independence among items was examined with Rasch modeling. Unidimensionality was tested by running a principal component analysis on the residuals. An exploratory factor analysis was used to examine the structure of the test, and a confirmatory factor analysis was used to evaluate the fit of the derived model. Results. The first residual component of the principal component analysis, with an eigenvalue of greater than 2, superseded the assumption of unidimensionality. After the omission of item 7 because of convergence problems, the exploratory factor analysis suggested that a 3-factor solution best fit the data. A confirmatory factor analysis demonstrated acceptable fit of the final model, although item 14 loaded poorly on its factor. Limitations. The sample size was on the lower end of what is generally recommended. Conclusions. This study could not confirm that the Mini-BESTest is unidimensional. Gait items were dispersed over all factors, indicating that they may reflect different constructs. Nonetheless, as there arguably is no clinical balance test superior to the Mini-BESTest today, we recommend using the total score for assessing gross balance in this population and individual items to identify specific weaknesses. Moreover, dual tasks should be assessed separately because they are an important aspect of balance control in people with PD, reflected in only one item of the test. [ABSTRACT FROM AUTHOR]

Background: The desirable effects of physical activity in individuals with Parkinson's disease are well-known, although according to results from previous studies factors associated with objectively assessed physical activity are not fully investigated. Objective: To investigate demographic, disease-related and mobility-related factors that associate with objectively measured physical activity, in a sample of older adults with mild to moderate Parkinson's disease. Methods: Demographic, disease-related and mobility-related factors were gathered by interview from a total of 91 older adults with Parkinson's disease, followed by an evaluation of balance control using the Mini-BESTest. After initial testing, participants wore a tri-axial accelerometer during a week of free-living. Correlation analysis and multiple linear regression was used to investigate factors associated with total PA, represented by total activity counts, and time in brisk walking. Results: Motor impairment, physical function, body mass index and dyskinesia contributed to the variance of total physical activity, explaining 34%of the variance, while physical function and balance control were significant factors associated with brisk walking, explaining 22 %. Conclusions: This study identified factors that have not been shown to associate with objectively measured physical activity previously, such as dyskinesia, balance control and self-rated physical function. The findings also demonstrated that associated factors differ, depending on the activity behavior being investigated. However, other factors than those included in this study may also be of importance. [ABSTRACT FROM AUTHOR]

Background. Decreased movement ability, one of the hallmarks of Parkinson disease (PD), may lead to inadequate physical activity (PA) and excessive time spent in sedentary behaviors--2 factors associated with an elevated risk for lifestyle-related diseases, poor management of PD, and premature death. To identify the extent to which people with PD are physically active, a comprehensive characterization of PA in this population is needed. Objective. The study objective was to describe levels and patterns of PA and sedentary behaviors in elderly people with PD. Design. This cross-sectional study involved a free-living setting and 53 men and 42 women (mean age=73-4 years) with mild to moderate idiopathic PD. Methods. Time spent in PA and sedentary behaviors was assessed for 1 week with accelerometers. Results. Mean daily step counts were 4,765; participants spent 589 minutes in sedentary behaviors, 141 minutes in low-intensity activities, 30 minutes in moderate-intensity lifestyle activities, and 16 minutes in moderate- to vigorous-intensity ambulatory activities. No differences were found between weekdays and weekend days. Patterns were characterized by a rise in total PA in the morning, peaking between 10 am and 3 pm, and a gradual decline toward the late evening. The proportion achieving 150 minutes of moderate- to vigorous-intensity PA per week was 27%, and 16% achieved 7,000 or more steps per day. Limitations. Nonrandomized selection of participants may limit the generalizabil-ity of the results. Conclusions. Physical activity levels were generally low, in terms of both total volume and intensity, with only minor variations over the course of a day or between days. These results emphasize the need to develop strategies to increase PA and reduce time spent in sedentary behaviors in elderly people with mild to moderate PD. [ABSTRACT FROM AUTHOR]