Changes in Walking Activity and Endurance Following Rehabilitation for People With Parkinson Disease
Abstract
White DK, Wagenaar RC, Ellis TD, Tickle-Degnen L. Changes in walking activity and endurance following rehabilitation for people with Parkinson disease.
Objective
To investigate changes in walking activity and endurance after interdisciplinary rehabilitation in people with Parkinson disease (PD).
Design
Randomized controlled trial.
Setting
Clinic, home, and community.
Participants
Mild to moderate PD (Hoehn and Yahr stage 2–3).
Interventions
Three experimental conditions lasting 6 weeks in duration: (1) no active rehabilitation; (2) 3.0 hours of interdisciplinary rehabilitation a week; or (3) 4.5 hours of interdisciplinary rehabilitation a week. Participants had stable medication regimes during the study.
Main Outcome Measures
Walking activity was estimated with an activity monitor (AM) (time spent walking and number of 10-second walking periods) in the home and community settings over a 24-hour period. Walking endurance was measured in the clinic with the two-minute walk test (2MWT). Linear contrast analyses were applied to examine changes in walking activity and endurance after higher doses of rehabilitation, and 2-way analysis of variance models with interaction were applied to examine the effect of high and low baseline walking levels on changes.
Results
The 2MWT was completed by 108 people with PD (mean age, 66.53y; with PD, 6.59y), and AM data were used from 74 of these people (mean age, 66.7y; with PD, 5.8y). Improvement in AM measures and the 2MWT did not significantly change across increasing dosages of interdisciplinary rehabilitation. Higher doses of rehabilitation resulted in significant improvements in the 2MWT for subjects with low baseline walking endurance (P=.001), and in AM measures for subjects with high baseline walking activity (P<.02).
Conclusions
Interdisciplinary rehabilitation can improve walking activity and endurance depending on baseline walking levels.
aClinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA
bDepartment of Physical Therapy and Athletic Training, Center for Neurorehabilitation, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA
cDepartment of Occupational Therapy, Tufts University, Medford, MA
Correspondence to Daniel K. White, PT, ScD, NCS, Post Doctoral Research Fellow, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA 02218
Supported by the National Institutes of Health/National Institute on Aging (grant no. R01AG021152, Rehabilitation for Self Management in Parkinson's disease).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT