Parkinson's disease in Jordan: Barriers and motivators to exercise.
BACKGROUND
Perceived barriers to engaging in exercise in people with Parkinson's disease (PD) are becoming more defined in countries such as the UK and the US. This, however, may vary by culture and environment. This study aimed to explore the perceptions of exercise and barriers that may affect participation in people with PD from Jordan.


METHODS
Two focus groups and seven individual interviews were conducted with people with PD. Additionally, individual interviews were conducted with two neurologists. Conversations were digitally recorded and transcribed. Transcripts were analyzed using thematic analysis and validated via researcher triangulation and peer checking.


RESULTS
Most of the PD participants lacked previous participation in any disease-specific exercises. Several barriers were perceived by PD participants for such lack of participation. Barriers included difficulty of diagnosis, lack of informational support provided by neurologists, lack of referral to physiotherapy services, disease-specific issues, and setting-related issues. Neurologists indicated a number of barriers in counseling their PD patients on exercise including lack of time and lack of health system resources. Motivators to participate in future exercise included outcome expectations and family support.


CONCLUSIONS
Findings of the study shed light into large areas of unmet needs of supporting exercise and physiotherapy for people with PD in developing countries as per Jordan. For better patient outcomes, findings of the study suggest that it is crucial to raise awareness among all PD-related stakeholders on the benefits of early referrals to physiotherapy and early engagement in exercise programs.
a Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences , Jordan University of Science and Technology , Irbid , Jordan.
Hanan
H
Khalil
a Faculty of Applied Medical Sciences, Department of Rehabilitation Sciences , Jordan University of Science and Technology , Irbid , Jordan.
Mohammad
M
Nazzal
b Faculty of Nursing, Department of Maternal and Child Health , Jordan University of Science and Technology , Irbid , Jordan.
Nihaya
N
Al-Sheyab
D000328:Adult; D000368:Aged; D015444:Exercise / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007597:Jordan; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*
Barriers; Jordan; Parkinson’s disease; exercise