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  1. Dear forum members, This is an interesting study that explored the barriers as to why people do not exercise with PD. Exercise seems to be very important so understanding the problem will be critical. Phys Ther. 2013 Jan 3. [Epub ahead of print] Barriers to Exercise in People With Parkinson Disease. Ellis T, Boudreau JK, Deangelis TR, Brown LE, Cavanaugh JT, Earhart GM, Ford MP, Foreman KB, Dibble LE. Source T. Ellis, PhD, PT, NCS, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent, Boston University, 635 Commonwealth Ave, Boston, MA 02215 (USA). Abstract BACKGROUND: Exercise is known to reduce disability and improve quality of life in persons with Parkinson disease (PD). Although barriers to exercise have been studied in older adults, barriers are not well defined in persons with chronic progressive neurological diseases, such as PD. OBJECTIVE: The purpose of this study was to identify perceived barriers to exercise among persons with PD. DESIGN: Cross-sectional METHODS: Community-dwelling individuals with PD (N= 260), mean age = 67.7 years, and Hoehn & Yahr = 2.4, participated in a cross-sectional study. Participants were categorized as exercisers (N= 164) or non-exercisers (N= 96). Subjects self-administered the barriers subscale of the Physical Fitness and Exercise Activity Levels of Older Adults Scale endorsing or denying specific barriers to exercise participation. Multivariate logistic regression analysis was used to examine the contribution of each barrier to exercise behavior and odds ratios were reported. RESULTS: Three barriers were retained in the multivariate regression model. Non-exercisers had significantly greater odds of endorsing low outcome expectation (OR= 3.93, 95% CI 2.08-7.42), lack of time (OR= 3.36, 95% CI 1.55-7.29) and fear of falling (OR= 2.35, 95% CI 1.17-4.71) compared to exercisers (p < 0.05). LIMITATIONS: The cross-sectional nature of the study limited our ability to make causal inferences. CONCLUSIONS: Low outcome expectation of exercise, lack of time to exercise, and fear of falling appear to be important perceived barriers to engaging in exercise among ambulatory, community-dwelling persons with PD. These may be important issues for physical therapists to target among patients with PD who are not regularly exercising. The efficacy of intervention strategies to facilitate exercise adherence in persons with PD requires further investigation.
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