Edinburgh Napier University

  Background: Parkinson's disease is a chronic, progressive neurological condition that is estimated to affect over 6 million people worldwide (EPDA 2014). Regular engagement in physical activity (PA) can bring health benefits for people with Parkinson's disease (pwPD), such as slowing physical deterioration and improving symptoms of Parkinson's disease. However, research suggests that many pwPD are inactive and encounter barriers to engaging in PA. Community exercise groups are a key resource in the promotion of PA, however, given the need for continuing engagement in PA over a number years for pwPD, greater understanding around the factors which contribute to long-term adherence to exercise groups is required.
Purpose: The purpose of this study was to explore pwPD experiences of PA. More specifically, to explore barriers and facilitators to PA and the experience of attending a long-term exercise group.
Methods: This study adopted a mixed methods approach combining a questionnaire and a focus group. A questionnaire, which included open and closed questions, was used to explore barriers and facilitators to PA for pwPD was sent to 200 members of the local branch of Parkinson's UK. The focus group was conducted with participants of an established community group for pwPD and thematic analysis of interview transcripts was undertaken.
Results: 77 questionnaires (38.5% response) were completed. Respondents had mean age of 71.9 years, 48 (62.3%) were male and mean time since diagnosis was 8.4 years. 60% of respondents cited physical barriers (such as PD symptoms) as the main limitation to undertaking PA, with 25% reporting psychological factors such as fear of falling and lack of motivation as their main barrier. The remaining 15% identified environmental restrictions such as lack of transport to the venue as the fundamental barrier to engaging in PA.
The focus group comprised eight participants (four males, mean age 71 years) who had been attending the community group for between two to 10 years with minimum time since diagnosis of six years. Four key themes arose from the analysis: (1) Benefits of attending the group: physical and psychological benefits; (2) The group as a motivator: the participants encouraged each other, there was a ‘good crowd’ and doing exercise together was ‘fun’; (3) Factors contributing to long-term success of the group included social support, fun, ownership of and accountability to the group; and (4) Barriers were identified as transport difficulties and the psychological effect of seeing people with more advanced PD.
Conclusion(s): Community exercise groups may be one means of encouraging long-term adherence to exercise, however barriers need to be overcome to ensure the success of the group.
Implications: A community exercise group can support long-term engagement of physical activity in pwPD. Barriers, such as difficulty with transport to attend groups, need to be addressed if groups are to be successful. Therefore, by highlighting the barriers, this project may serve to facilitate the design of further successful exercise groups.