title: Toward Understanding Ambulatory Activity Decline in Parkinson Disease.
abstract: BACKGROUND
  Declining ambulatory activity represents an important facet of disablement in Parkinson disease (PD).
  
  
  OBJECTIVE
  The primary study aim was to compare the 2-year trajectory of ambulatory activity decline with concurrently evolving facets of disability in a small cohort of people with PD. The secondary aim was to identify baseline variables associated with ambulatory activity at 1- and 2-year follow-up assessments.
  
  
  METHODS
  This was a prospective, longitudinal cohort study.
  
  
  METHODS
  Seventeen people with PD (Hoehn and Yahr stages 1-3) were recruited from 2 outpatient settings. Ambulatory activity data were collected at baseline and at 1- and 2-year annual assessments. Motor, mood, balance, gait, upper extremity function, quality of life, self-efficacy, and levodopa equivalent daily dose data and data on activities of daily living also were collected.
  
  
  RESULTS
  Participants displayed significant 1- and 2-year declines in the amount and intensity of ambulatory activity concurrently with increasing levodopa equivalent daily dose. Worsening motor symptoms and slowing of gait were apparent only after 2 years. Concurrent changes in the remaining clinical variables were not observed. Baseline ambulatory activity and physical performance variables had the strongest relationships with 1- and 2-year mean daily steps.
  
  
  CONCLUSIONS
  The sample was small and homogeneous.
  
  
  CONCLUSIONS
  Future research that combines ambulatory activity monitoring with a broader and more balanced array of measures would further illuminate the dynamic interactions among evolving facets of disablement and help determine the extent to which sustained patterns of recommended daily physical activity might slow the rate of disablement in PD.
authors: J.T. Cavanaugh, PT, PhD, Department of Physical Therapy, University of New England, Portland, ME 04103 (USA). jcavanaugh@une.edu.
authors: James T
authors: JT
authors: Cavanaugh
authors: T.D. Ellis, PT, PhD, Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts.
authors: Terry D
authors: TD
authors: Ellis
authors: G.M. Earhart, PT, PhD, Program in Physical Therapy, School of Medicine, Washington University, St Louis, Missouri.
authors: Gammon M
authors: GM
authors: Earhart
authors: M.P. Ford, PT, PhD, Department of Physical Therapy, Samford University, Birmingham, Alabama.
authors: Matthew P
authors: MP
authors: Ford
authors: K.B. Foreman, PT, PhD, Department of Physical Therapy, University of Utah, Salt Lake City, Utah.
authors: K Bo
authors: KB
authors: Foreman
authors: L.E. Dibble, PT, PhD, Department of Physical Therapy, University of Utah.
authors: Leland E
authors: LE
authors: Dibble
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D004856:Postural Balance; D011446:Prospective Studies; D011788:Quality of Life; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa