title: Regular exercise and related factors in patients with Parkinson's disease: Applying zero-inflated negative binomial modeling of exercise count data.
abstract: OBJECTIVE
  This study was conducted to identify risk factors that influence regular exercise among patients with Parkinson's disease in Korea. Parkinson's disease is prevalent in the elderly, and may lead to a sedentary lifestyle. Exercise can enhance physical and psychological health. However, patients with Parkinson's disease are less likely to exercise than are other populations due to physical disability.
  
  
  METHODS
  A secondary data analysis and cross-sectional descriptive study were conducted. A convenience sample of 106 patients with Parkinson's disease was recruited at an outpatient neurology clinic of a tertiary hospital in Korea. Demographic characteristics, disease-related characteristics (including disease duration and motor symptoms), self-efficacy for exercise, balance, and exercise level were investigated. Negative binomial regression and zero-inflated negative binomial regression for exercise count data were utilized to determine factors involved in exercise.
  
  
  RESULTS
  The mean age of participants was 65.85 ± 8.77 years, and the mean duration of Parkinson's disease was 7.23 ± 6.02 years. Most participants indicated that they engaged in regular exercise (80.19%). Approximately half of participants exercised at least 5 days per week for 30 min, as recommended (51.9%). Motor symptoms were a significant predictor of exercise in the count model, and self-efficacy for exercise was a significant predictor of exercise in the zero model.
  
  
  CONCLUSIONS
  Severity of motor symptoms was related to frequency of exercise. Self-efficacy contributed to the probability of exercise. Symptom management and improvement of self-efficacy for exercise are important to encourage regular exercise in patients with Parkinson's disease.
authors.affiliation: Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro #510, Seodaemun-gu, Seoul, South Korea, 03722. Electronic address: JHL@yuhs.ac.
authors.forename: JuHee
authors.initials: J
authors.lastname: Lee
authors.affiliation: College of Nursing, University of Illinois at Chicago, 946 South Damen Avenue #612, Chicago, IL, 60612, USA. Electronic address: parkch@uic.edu.
authors.forename: Chang Gi
authors.initials: CG
authors.lastname: Park
authors.affiliation: College of Nursing, Yonsei University, 50-1 Yonsei-ro #511, Seodaemun-gu, Seoul, South Korea, 03722. Electronic address: miyamoong@yuhs.ac.
authors.forename: Moonki
authors.initials: M
authors.lastname: Choi
mesh_terms: D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology*
keywords: Exercise; Neurologic manifestations; Parkinson’s disease; Postural balance; Self-efficacy