Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial
Identifieur interne : 000E29 ( Main/Corpus ); précédent : 000E28; suivant : 000E30Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial
Auteurs : Marlies Van Nimwegen ; Arlène D. Speelman ; Sebastiaan Overeem ; Bart P. Van De Warrenburg ; Katrijn Smulders ; Manon L. Dontje ; George F. Borm ; Frank J G. Backx ; Bastiaan R. Bloem ; Marten MunnekeSource :
- BMJ : British Medical Journal [ 1756-1833 ] ; 2013.
Abstract
Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease. Trial registration Clinical trials NCT00748488.
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DOI: 10.1136/bmj.f576
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Dontje</name><affiliation><mods:affiliation>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Borm, George F" sort="Borm, George F" uniqKey="Borm G" first="George F" last="Borm">George F. Borm</name><affiliation><mods:affiliation>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Backx, Frank J G" sort="Backx, Frank J G" uniqKey="Backx F" first="Frank J G" last="Backx">Frank J G. Backx</name><affiliation><mods:affiliation>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><affiliation><mods:affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2CD60F03B30D4CA058346177A96E869E1E1E07B9</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/bmj.f576</idno><idno type="url">https://api.istex.fr/document/2CD60F03B30D4CA058346177A96E869E1E1E07B9/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000E29</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial</title><author><name sortKey="Van Nimwegen, Marlies" sort="Van Nimwegen, Marlies" uniqKey="Van Nimwegen M" first="Marlies" last="Van Nimwegen">Marlies Van Nimwegen</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Speelman, Arlene D" sort="Speelman, Arlene D" uniqKey="Speelman A" first="Arlène D" last="Speelman">Arlène D. Speelman</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Overeem, Sebastiaan" sort="Overeem, Sebastiaan" uniqKey="Overeem S" first="Sebastiaan" last="Overeem">Sebastiaan Overeem</name><affiliation><mods:affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Van De Warrenburg, Bart P" sort="Van De Warrenburg, Bart P" uniqKey="Van De Warrenburg B" first="Bart P" last="Van De Warrenburg">Bart P. Van De Warrenburg</name><affiliation><mods:affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Smulders, Katrijn" sort="Smulders, Katrijn" uniqKey="Smulders K" first="Katrijn" last="Smulders">Katrijn Smulders</name><affiliation><mods:affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>HAN University of Applied Sciences, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Dontje, Manon L" sort="Dontje, Manon L" uniqKey="Dontje M" first="Manon L" last="Dontje">Manon L. Dontje</name><affiliation><mods:affiliation>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Borm, George F" sort="Borm, George F" uniqKey="Borm G" first="George F" last="Borm">George F. Borm</name><affiliation><mods:affiliation>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Backx, Frank J G" sort="Backx, Frank J G" uniqKey="Backx F" first="Frank J G" last="Backx">Frank J G. Backx</name><affiliation><mods:affiliation>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><affiliation><mods:affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author><author><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><affiliation><mods:affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: B.Bloem@neuro.umcn.nl</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date>2013</date><biblScope unit="volume">346</biblScope></imprint></series><idno type="istex">2CD60F03B30D4CA058346177A96E869E1E1E07B9</idno><idno type="DOI">10.1136/bmj.f576</idno><idno type="href">bmj-346-bmj-f576.pdf</idno><idno type="ArticleID">vanm006637</idno><idno type="local">bmj;346/mar01_2/f576</idno></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease. Trial registration Clinical trials NCT00748488.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Marlies van Nimwegen</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Arlène D Speelman</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Sebastiaan Overeem</name><affiliations><json:string>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Bart P van de Warrenburg</name><affiliations><json:string>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Katrijn Smulders</name><affiliations><json:string>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</json:string><json:string>HAN University of Applied Sciences, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Manon L Dontje</name><affiliations><json:string>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</json:string><json:string>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>George F Borm</name><affiliations><json:string>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Frank J G Backx</name><affiliations><json:string>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Bastiaan R Bloem</name><affiliations><json:string>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item><json:item><name>Marten Munneke</name><affiliations><json:string>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</json:string><json:string>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</json:string><json:string>E-mail: B.Bloem@neuro.umcn.nl</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Research</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P>0.001), the activity monitor (difference 12%; P>0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease. 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(INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>British Medical Journal Publishing Group</publisher><availability><p>BMJ</p></availability><date>2013</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial</title><author><persName><forename type="first">Marlies</forename><surname>van Nimwegen</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">physiotherapist and research scientist</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>physiotherapist and research scientist</affiliation><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Arlène D</forename><surname>Speelman</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">physiotherapist and research scientist</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>physiotherapist and research scientist</affiliation><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Sebastiaan</forename><surname>Overeem</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">research scientist</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>research scientist</affiliation><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Bart P</forename><surname>van de Warrenburg</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">medical doctor</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>medical doctor</affiliation><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Katrijn</forename><surname>Smulders</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">research scientist</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>research scientist</affiliation><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>HAN University of Applied Sciences, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Manon L</forename><surname>Dontje</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">research scientist</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>research scientist</affiliation><affiliation>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</affiliation><affiliation>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</affiliation></author><author><persName><forename type="first">George F</forename><surname>Borm</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">professor in biostatistics</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>professor in biostatistics</affiliation><affiliation>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Frank J G</forename><surname>Backx</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">professor in clinical sports medicine</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>professor in clinical sports medicine</affiliation><affiliation>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</affiliation></author><author corresp="yes"><persName><forename type="first">Bastiaan R</forename><surname>Bloem</surname></persName><email>B.Bloem@neuro.umcn.nl</email><email>B.Bloem@neuro.umcn.nl</email><note type="biography">professor in neurology</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>professor in neurology</affiliation><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation></author><author><persName><forename type="first">Marten</forename><surname>Munneke</surname></persName><email>B.Bloem@neuro.umcn.nl</email><note type="biography">physiotherapist and associate professor in health care innovation</note><note type="correspondence"><p>Correspondence to: B R Bloem</p></note><affiliation>physiotherapist and associate professor in health care innovation</affiliation><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation><affiliation>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation></author></analytic><monogr><title level="j">BMJ : British Medical Journal</title><title level="j" type="abbrev">BMJ</title><idno type="eISSN">1756-1833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date>2013</date><biblScope unit="volume">346</biblScope></imprint></monogr><idno type="istex">2CD60F03B30D4CA058346177A96E869E1E1E07B9</idno><idno type="DOI">10.1136/bmj.f576</idno><idno type="href">bmj-346-bmj-f576.pdf</idno><idno type="ArticleID">vanm006637</idno><idno type="local">bmj;346/mar01_2/f576</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease. Trial registration Clinical trials NCT00748488.</p></abstract></profileDesc><revisionDesc><change>undefined</change><change>[object Object]</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/2CD60F03B30D4CA058346177A96E869E1E1E07B9/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">bmj</journal-id><journal-id journal-id-type="nlm-ta">BMJ</journal-id><journal-id journal-id-type="publisher-id">bmj</journal-id><journal-title>BMJ : British Medical Journal</journal-title><issn pub-type="epub">1756-1833</issn><publisher><publisher-name>British Medical Journal Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">vanm006637</article-id><article-id pub-id-type="doi">10.1136/bmj.f576</article-id><article-id pub-id-type="other">bmj;346/mar01_2/f576</article-id><article-id pub-id-type="other">bmj;bmj.f576</article-id><article-id pub-id-type="other">mar01_2</article-id><article-id pub-id-type="other">bmj.f576</article-id><article-id pub-id-type="other">bmj.f576</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="no"><name><surname>van Nimwegen</surname><given-names>Marlies</given-names></name><role>physiotherapist and research scientist</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Speelman</surname><given-names>Arlène D</given-names></name><role>physiotherapist and research scientist</role><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Overeem</surname><given-names>Sebastiaan</given-names></name><role>research scientist</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>van de Warrenburg</surname><given-names>Bart P</given-names></name><role>medical doctor</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Smulders</surname><given-names>Katrijn</given-names></name><role>research scientist</role><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Dontje</surname><given-names>Manon L</given-names></name><role>research scientist</role><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="aff" rid="aff5">5</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Borm</surname><given-names>George F</given-names></name><role>professor in biostatistics</role><xref ref-type="aff" rid="aff6">6</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Backx</surname><given-names>Frank J G</given-names></name><role>professor in clinical sports medicine</role><xref ref-type="aff" rid="aff7">7</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Bloem</surname><given-names>Bastiaan R</given-names></name><role>professor in neurology</role><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="no"><name><surname>Munneke</surname><given-names>Marten</given-names></name><role>physiotherapist and associate professor in health care innovation</role><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff8">8</xref></contrib><on-behalf-of>on behalf of the ParkFit Study Group</on-behalf-of><aff id="aff1"><label>1</label>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</aff><aff id="aff2"><label>2</label>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</aff><aff id="aff3"><label>3</label>HAN University of Applied Sciences, Nijmegen, Netherlands</aff><aff id="aff4"><label>4</label>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</aff><aff id="aff5"><label>5</label>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</aff><aff id="aff6"><label>6</label>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</aff><aff id="aff7"><label>7</label>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</aff><aff id="aff8"><label>8</label>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</aff></contrib-group><author-notes><corresp>Correspondence to: B R Bloem <email>B.Bloem@neuro.umcn.nl</email></corresp></author-notes><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub-original"><year>2013</year></pub-date><volume>346</volume><volume-id pub-id-type="other">346</volume-id><volume-id pub-id-type="other">346</volume-id><elocation-id>f576</elocation-id><permissions><copyright-statement>© van Nimwegen et al 2013</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>van Nimwegen et al</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/</ext-link> and <ext-link xlink:href="http://creativecommons.org/licenses/by-nc/2.0/legalcode" ext-link-type="uri">http://creativecommons.org/licenses/by-nc/2.0/legalcode</ext-link>.</p></license></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="bmj-346-bmj-f576.pdf"></self-uri><abstract><p><bold>Objective</bold> To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease.</p><p><bold>Design</bold> Multicentre randomised controlled trial.</p><p><bold>Setting</bold> 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet).</p><p><bold>Participants</bold> 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3).</p><p><bold>Intervention</bold> Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback).</p><p><bold>Main outcome measures</bold> The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test).</p><p><bold>Results</bold> 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%).</p><p><bold>Conclusions</bold> The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease.</p><p><bold>Trial registration</bold> Clinical trials <ext-link ext-link-type="clintrialgov" xlink:href="NCT00748488">NCT00748488</ext-link>.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial</title></titleInfo><name type="personal"><namePart type="given">Marlies</namePart><namePart type="family">van Nimwegen</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>physiotherapist and research scientist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arlène D</namePart><namePart type="family">Speelman</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>physiotherapist and research scientist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sebastiaan</namePart><namePart type="family">Overeem</namePart><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>research scientist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bart P</namePart><namePart type="family">van de Warrenburg</namePart><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>medical doctor</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katrijn</namePart><namePart type="family">Smulders</namePart><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>HAN University of Applied Sciences, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>research scientist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Manon L</namePart><namePart type="family">Dontje</namePart><affiliation>Hanze University of Applied Sciences, Research and Innovation Group in Health Care and Nursing, Groningen, Netherlands</affiliation><affiliation>Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>research scientist</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">George F</namePart><namePart type="family">Borm</namePart><affiliation>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>professor in biostatistics</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frank J G</namePart><namePart type="family">Backx</namePart><affiliation>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>professor in clinical sports medicine</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Bastiaan R</namePart><namePart type="family">Bloem</namePart><affiliation>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>professor in neurology</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marten</namePart><namePart type="family">Munneke</namePart><affiliation>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation><affiliation>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen, Netherlands</affiliation><affiliation>E-mail: B.Bloem@neuro.umcn.nl</affiliation><description>Correspondence to: B R Bloem </description><description>physiotherapist and associate professor in health care innovation</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>British Medical Journal Publishing Group</publisher><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson’s disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Participants 586 sedentary patients with idiopathic Parkinson’s disease aged between 40 and 75 years with mild to moderate disease severity (Hoehn and Yahr stage ≤3). Intervention Patients were randomly assigned to the ParkFit programme or a matched general physiotherapy intervention. ParkFit is a multifaceted behavioural change programme, designed specifically to achieve an enduring increase in the level of physical activity (coaches using motivational strategies; ambulatory feedback). Main outcome measures The primary endpoint was the level of physical activity, measured every six months with a standardised seven day recall (LASA physical activity questionnaire—LAPAQ). Secondary endpoints included two other measures of physical activity (activity diary and ambulatory activity monitor), quality of life (Parkinson’s disease questionnaire—PDQ-39), and fitness (six minute walk test). Results 540 (92.2%) patients completed the primary outcome. During follow-up, overall time spent on physical activities (LAPAQ) was comparable between the groups (adjusted group difference 7%, 95% confidence interval −3 to 17%; P=0.19). Analyses of three secondary outcomes indicated increased physical activity in ParkFit patients, as suggested by the activity diary (difference 30%; P<0.001), the activity monitor (difference 12%; P<0.001), and the six minute walk test (difference 4.8 m; P=0.05). PDQ-39 did not differ between ParkFit patients and controls (difference −0.9 points; P=0.14). The number of fallers was comparable between ParkFit patients (184/299; 62%) and controls (191/287; 67%). Conclusions The ParkFit behavioural change programme did not increase overall physical activity, as measured with the LAPAQ. The analysis of the secondary endpoints justifies further work into the possible merits of behavioural change programmes to increase physical activities in daily life in Parkinson’s disease. Trial registration Clinical trials NCT00748488.</abstract><relatedItem type="host"><titleInfo><title>BMJ : British Medical Journal</title></titleInfo><titleInfo type="abbreviated"><title>BMJ</title></titleInfo><genre type="Journal">journal</genre><identifier type="eISSN">1756-1833</identifier><identifier type="PublisherID">bmj</identifier><identifier type="PublisherID-hwp">bmj</identifier><identifier type="PublisherID-nlm-ta">BMJ</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>346</number></detail></part></relatedItem><identifier type="istex">2CD60F03B30D4CA058346177A96E869E1E1E07B9</identifier><identifier type="DOI">10.1136/bmj.f576</identifier><identifier type="href">bmj-346-bmj-f576.pdf</identifier><identifier type="ArticleID">vanm006637</identifier><identifier type="local">bmj;346/mar01_2/f576</identifier><accessCondition type="use and reproduction" contentType="open-access">This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. 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