title: Quantifying daily physical activity and determinants in sedentary patients with Parkinson's disease.
abstract: BACKGROUND
  Although physical activity is beneficial for Parkinson's disease (PD) patients, many do not meet the recommended levels. The range of physical activity among sedentary PD patients is unknown, as are factors that determine this variability. Hence, we aimed to (1) assess daily physical activity in self-identified sedentary PD patients; (2) compare this with criteria of a daily physical activity guideline; and (3) identify determinants of daily physical activity.
  
  
  METHODS
  Daily physical activity of 586 self-identified sedentary PD patients was measured with a tri-axial accelerometer for seven consecutive days. Physical fitness and demographic, disease-specific, and psychological characteristics were assessed. Daily physical activity was compared with the 30-min activity guideline. A linear mixed-effects model was estimated to identify determinants of daily physical activity.
  
  
  RESULTS
  Accelerometer data of 467 patients who fulfilled all criteria revealed that >98% of their day was spent on sedentary to light-intensity activities. Eighty-two percent of the participants were 'physically inactive' (0 days/week of 30-min activity); 17% were 'semi-active' (1-4 days/week of 30-min activity). Age, gender, physical fitness, and scores on the Unified Parkinson's Disease Rating Scale explained 69% of the variability in daily physical activity.
  
  
  CONCLUSIONS
  Performance-based measurements confirmed that most self-identified sedentary PD patients are 'physically inactive'. However, the variance in daily physical activity across subjects was considerable. Higher age, being female, and lower physical capacity were the most important determinants of reduced daily physical activity. Future therapeutic interventions should aim to improve daily physical activity in these high-risk patients, focusing specifically on modifiable risk factors.
authors.affiliation: Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands. m.l.dontje@pl.hanze.nl
authors.forename: M L
authors.initials: ML
authors.lastname: Dontje
authors.forename: M H G
authors.initials: MH
authors.lastname: de Greef
authors.forename: A D
authors.initials: AD
authors.lastname: Speelman
authors.forename: M
authors.initials: M
authors.lastname: van Nimwegen
authors.forename: W P
authors.initials: WP
authors.lastname: Krijnen
authors.forename: R P
authors.initials: RP
authors.lastname: Stolk
authors.forename: Y P T
authors.initials: YP
authors.lastname: Kamsma
authors.forename: B R
authors.initials: BR
authors.lastname: Bloem
authors.forename: M
authors.initials: M
authors.lastname: Munneke
authors.forename: C P
authors.initials: CP
authors.lastname: van der Schans
mesh_terms: D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D015992:Body Mass Index; D003863:Depression / Q000523:psychology; D004522:Educational Status; D004734:Energy Metabolism; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009426:Netherlands; D010300:Parkinson Disease / Q000523:psychology*; D010809:Physical Fitness / Q000502:physiology; D057185:Sedentary Behavior; D020377:Self Efficacy; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Health behavior; Parkinson's disease; Physical activity; Physical fitness