Objectives:
International physical activity guidelines recommend that adults should engage in at least 150 minutes of moderate intensity exercise each week. The neurological population are not as physically active as age-matched controls, do not meet current physical activity guidelines and barriers to exercise exist within this population (Ellis et al. 2013).
The aims of this study were to assess physical activity levels and barriers to exercise in a neurological population attending Tallaght hospital physiotherapy department. The objectives were;
- To investigate physical activity levels of this neurological population.
- To compare findings against recommended physical activity guidelines.
- To investigate barriers to exercise for this population.
Methods:
In-patients and out-patients who were referred to the neurological physiotherapy service between September 2016 and January 2017 were invited to participate. Written consent was obtained from each participant and ethical approval was sought and approved by the SJH/AMNCH Ethics Committee. Data collected included gender, diagnosis and date of diagnosis. Each participant’s current mobility level was recorded and grouped into 3 categories: Independent; Independent with a mobility aid; assistance with a mobility aid. All participants completed the International Physical Activity Questionnaire –Short Form (IPAQ-SF), a validated tool to assess physical activity levels. Patients also completed a subjective rating scale, ranking five of the most commonly reported barriers to exercise for this population. Questionnaires were anonymised and data coded. Results were analysed using descriptive statistics.
Results:
34 participants completed the IPAQ-SF (21 Male, 13 Female). Diagnoses included Parkinson Disease, Ataxia, Guillain-Barre syndrome, Multiple Sclerosis, functional neurological disorders and stroke. In total 76% of participants were out-patients. Mean length of time from diagnosis to study inclusion was 56 months (1-324 months). It was found that 70.6% of patients surveyed were independently mobile, 14.7% were independent with a mobility aid and 14.7% needed assistance with a mobility aid. The main barriers to exercise in this population were the physical impairments caused by the condition itself (56%), followed by lack of education around physical activity (32%). Results from the IPAQ-SF showed that, 44% of participants are physically inactive, 44% minimally active and only 12% were meeting current recommended guidelines. The proportion of neurological patients who were sufficiently active (12%) was significantly lower than that observed in healthy controls in the Healthy Ireland Study 2015 (32%, p <0.002).
Conclusion:
This cohort of neurological patients did not meet recommended guidelines for physical activity and are significantly more inactive than age-matched norms. Barriers to exercise have been identified. Physiotherapy input may influence some of the main barriers for this patient population by improving education regarding condition-specific physical activity and introducing ‘condition-tailored exercises’ to promote greater participation in exercise.
References:
Healthy Ireland Study (2015) Department of Health. Available at: www.healthyireland.ie
Ellis, T., Boudreau, J. K., DeAngelis, T. R., Brown, L. E., Cavanaugh, J. T., Earhart, G. M. Dibble, L. E. (2013). Barriers to Exercise in People with Parkinson Disease. Physical Therapy, 93(5), 628–636.
