title: Factors Associated With Ambulatory Activity in De Novo Parkinson Disease.
abstract: OBJECTIVE
  Objective ambulatory activity during daily living has not been characterized for people with Parkinson disease prior to initiation of dopaminergic medication. Our goal was to characterize ambulatory activity based on average daily step count and examine determinants of step count in nonexercising people with de novo Parkinson disease.
  
  
  METHODS
  We analyzed baseline data from a randomized controlled trial, which excluded people performing regular endurance exercise. Of 128 eligible participants (mean ± SD = 64.3 ± 8.6 years), 113 had complete accelerometer data, which were used to determine daily step count. Multiple linear regression was used to identify factors associated with average daily step count over 10 days. Candidate explanatory variable categories were (1) demographics/anthropometrics, (2) Parkinson disease characteristics, (3) motor symptom severity, (4) nonmotor and behavioral characteristics, (5) comorbidities, and (6) cardiorespiratory fitness.
  
  
  RESULTS
  Average daily step count was 5362 ± 2890 steps per day. Five factors explained 24% of daily step count variability, with higher step count associated with higher cardiorespiratory fitness (10%), no fear/worry of falling (5%), lower motor severity examination score (4%), more recent time since Parkinson disease diagnosis (3%), and the presence of a cardiovascular condition (2%).
  
  
  CONCLUSIONS
  Daily step count in nonexercising people recruited for this intervention trial with de novo Parkinson disease approached sedentary lifestyle levels. Further study is warranted for elucidating factors explaining ambulatory activity, particularly cardiorespiratory fitness, and fear/worry of falling. Clinicians should consider the costs and benefits of exercise and activity behavior interventions immediately after diagnosis of Parkinson disease to attenuate the health consequences of low daily step count.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A170).
authors.affiliation: Department of Physical Medicine and Rehabilitation (C.C., M.S.), Department of Neurology (B.K., B.B.), Division of Geriatric Medicine (W.K., T.W., E.M.), and Division of Endocrinology, Metabolism, and Diabetes (E.M.), University of Colorado School of Medicine, Aurora, Colorado; Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado (C.C.); Dickson Advanced Analytics, Carolinas HealthCare System, Charlotte, North Carolina (C.M.); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania (A.D., D.J.); Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois (D.H., C.C.); Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois (C.P., D.C.); Department of Physical Therapy, University of Illinois at Chicago, Chicago Illinois (J.R.); and Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (S.J.).
authors.forename: Cory
authors.initials: C
authors.lastname: Christiansen
authors.forename: Charity
authors.initials: C
authors.lastname: Moore
authors.forename: Margaret
authors.initials: M
authors.lastname: Schenkman
authors.forename: Benzi
authors.initials: B
authors.lastname: Kluger
authors.forename: Wendy
authors.initials: W
authors.lastname: Kohrt
authors.forename: Anthony
authors.initials: A
authors.lastname: Delitto
authors.forename: Brian
authors.initials: B
authors.lastname: Berman
authors.forename: Deborah
authors.initials: D
authors.lastname: Hall
authors.forename: Deborah
authors.initials: D
authors.lastname: Josbeno
authors.forename: Cynthia
authors.initials: C
authors.lastname: Poon
authors.forename: Julie
authors.initials: J
authors.lastname: Robichaud
authors.forename: Toby
authors.initials: T
authors.lastname: Wellington
authors.forename: Samay
authors.initials: S
authors.lastname: Jain
authors.forename: Cynthia
authors.initials: C
authors.lastname: Comella
authors.forename: Daniel
authors.initials: D
authors.lastname: Corcos
authors.forename: Ed
authors.initials: E
authors.lastname: Melanson
mesh_terms: D061725:Accelerometry; D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology* / Q000523:psychology