Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial
Identifieur interne : 000002 ( Main/Exploration ); précédent : 000001; suivant : 000003Promotion of physical activity and fitness in sedentary patients with Parkinson’s disease: randomised controlled trial
Auteurs : Marlies Van Nimwegen [Pays-Bas] ; Arlène D. Speelman [Pays-Bas] ; Sebastiaan Overeem [Pays-Bas] ; Bart P. Van De Warrenburg [Pays-Bas] ; Katrijn Smulders [Pays-Bas] ; Manon L. Dontje [Pays-Bas] ; George F. Borm [Pays-Bas] ; Frank J G. Backx [Pays-Bas] ; Bastiaan R. Bloem [Pays-Bas] ; Marten Munneke [Pays-Bas]Source :
- 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.
Url:
DOI: 10.1136/bmj.f576
Affiliations:
- Pays-Bas
- Groningue (province), Gueldre, Utrecht (province)
- Groningue, Nimègue, Utrecht
- Université de Groningue
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Borm</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></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 wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation, Nursing Science and Sport, University Medical Centre Utrecht, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></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 wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></affiliation></author><author><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Pays-Bas</country></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><affiliations><list><country><li>Pays-Bas</li></country><region><li>Groningue (province)</li><li>Gueldre</li><li>Utrecht (province)</li></region><settlement><li>Groningue</li><li>Nimègue</li><li>Utrecht</li></settlement><orgName><li>Université de Groningue</li></orgName></list><tree><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Van Nimwegen, Marlies" sort="Van Nimwegen, Marlies" uniqKey="Van Nimwegen M" first="Marlies" last="Van Nimwegen">Marlies Van Nimwegen</name></region><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><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><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><name sortKey="Bloem, Bastiaan R" sort="Bloem, Bastiaan R" uniqKey="Bloem B" first="Bastiaan R" last="Bloem">Bastiaan R. Bloem</name><name sortKey="Borm, George F" sort="Borm, George F" uniqKey="Borm G" first="George F" last="Borm">George F. Borm</name><name sortKey="Borm, George F" sort="Borm, George F" uniqKey="Borm G" first="George F" last="Borm">George F. Borm</name><name sortKey="Dontje, Manon L" sort="Dontje, Manon L" uniqKey="Dontje M" first="Manon L" last="Dontje">Manon L. Dontje</name><name sortKey="Dontje, Manon L" sort="Dontje, Manon L" uniqKey="Dontje M" first="Manon L" last="Dontje">Manon L. Dontje</name><name sortKey="Dontje, Manon L" sort="Dontje, Manon L" uniqKey="Dontje M" first="Manon L" last="Dontje">Manon L. Dontje</name><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><name sortKey="Munneke, Marten" sort="Munneke, Marten" uniqKey="Munneke M" first="Marten" last="Munneke">Marten Munneke</name><name sortKey="Overeem, Sebastiaan" sort="Overeem, Sebastiaan" uniqKey="Overeem S" first="Sebastiaan" last="Overeem">Sebastiaan Overeem</name><name sortKey="Overeem, Sebastiaan" sort="Overeem, Sebastiaan" uniqKey="Overeem S" first="Sebastiaan" last="Overeem">Sebastiaan Overeem</name><name sortKey="Smulders, Katrijn" sort="Smulders, Katrijn" uniqKey="Smulders K" first="Katrijn" last="Smulders">Katrijn Smulders</name><name sortKey="Smulders, Katrijn" sort="Smulders, Katrijn" uniqKey="Smulders K" first="Katrijn" last="Smulders">Katrijn Smulders</name><name sortKey="Smulders, Katrijn" sort="Smulders, Katrijn" uniqKey="Smulders K" first="Katrijn" last="Smulders">Katrijn Smulders</name><name sortKey="Speelman, Arlene D" sort="Speelman, Arlene D" uniqKey="Speelman A" first="Arlène D" last="Speelman">Arlène D. Speelman</name><name sortKey="Speelman, Arlene D" sort="Speelman, Arlene D" uniqKey="Speelman A" first="Arlène D" last="Speelman">Arlène D. Speelman</name><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><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><name sortKey="Van Nimwegen, Marlies" sort="Van Nimwegen, Marlies" uniqKey="Van Nimwegen M" first="Marlies" last="Van Nimwegen">Marlies Van Nimwegen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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