Being limited by Parkinson's disease and struggling to keep up exercising; is the group the glue?

Background: People with Parkinson's disease find that exercise helps to improve their physical performance. However, when performed in a group, they also tend to appreciate each other's company.Purpose: After people with Parkinson's disease participated in a community-based group balance exercise program, our aims were to explore the participants' general attitude to their balance ability and exercise, and specifically their experiences of participating in a group exercise.Materials and Methods: Informants were people living with Parkinson's disease at an early stage (n = 15) who had participated in a community-based "Somatosensory Focused Balance Training without Cues." Each informant took part in one face-to-face interview. The interviews were transcribed, according to content analysis, coded independently by two researchers and triangulated together with a third experienced researcher. Categories and themes were derived in consensus.Results: The participants felt limited by their body. They agreed that the group balance exercise program did help with their balance control. Moreover, the vast majority found that the group context implied a positive social contribution to their lives and to their ability to cope with living with the disease.Conclusion: Group balance exercise might constitute a context with potential to improve quality of life for people with Parkinson's disease, not only by improving balance control, but also contributing to social connections, fellowship and the exchange of mutual experiences.Implications for rehabilitationGroup-based exercise in early Parkinson seems to add more than just the physical effects of training, since it also gives a platform for meeting social and emotional needs, as well as addressing physical ability.The group dynamics and the support of peers seem to promote a positive attitude to life and enable people to learn coping strategies from each other.Community-based exercise groups for people with early Parkinson seem to be a way to get out in society and regain a feeling of being part of society.Due to body limits, people with Parkinson's disease must struggle daily, already at an early stage of their disease; this stresses the need to begin rehabilitation early.

High concurrent presence of disability in multiple sclerosis. Associations with perceived health.

OBJECTIVES: (1) To explore functioning and concurrent presence of disabilities - concerning cognition, manual dexterity, walking, energy, mood, activities of daily living (ADL), and social/lifestyle activities - in persons with multiple sclerosis (PwMS) cared for at an outpatient MS clinic. 2) To describe the PwMS' perceived physical and psychological impact and associations with the same disabilities. MATERIAL/METHODS: A descriptive cross-sectional study was carried out in 219 PwMS at the MS Centre, Karolinska University Hospital. Logistic regression employing proportional odds models was used to identify the associations of the disabilities with the perceived physical and psychological impact. RESULTS: In this sample the distribution with regard to disease severity as per Expanded Disability Status Scale was; mild 59.5%, moderate 17% and severe 23.5%. Despite the high proportion with mild disease severity disability regarding cognition was found in 49%, manual dexterity 76%, walking 43%, energy 67%, mood 29%, ADL 44% and social/lifestyle activities in 48%. Two or more disabilities were found in 80%, 24 % had six or seven disabilities. Disability regarding energy, mood, walking, manual dexterity and ADL was significantly associated with increase in the perceived physical impact, whereas disability in energy and mood was significantly associated with increase in the perceived psychological impact. CONCLUSIONS: The presence of several concurrent disabilities, some significantly associated with high perceived physical and psychological impact, in the majority of PwMS in outpatient clinics highlights the importance to identify disabilities, in particular fatigue and depressed mood, in order to supply health care interventions aiming to improve the life situation of PwMS.

Assessing postural balance in early Parkinson's Disease-validity of the BDL balance scale.

BACKGROUND: There is a need for a valid assessment test of balance in early Parkinson's disease (PD). OBJECTIVE: To validate the Bäckstrand Dahlberg Liljenäs Balance Scale (BDL), a test of balance performance constructed to assess mild to moderate balance disability due to neurological disease, for use in persons with early PD. METHODS: Cross-sectional psychometric evaluation study from a convenience sample community-dwelling persons with PD (n = 28). MAIN MEASURES: The BDL was validated using the Berg Balance Scale (BBS), the motor part of the Unified Parkinson's Disease Rating Scale (mUPDRS), the Timed Up and Go (TUG) and Timed Up and Go-cognition (CTUG). Correlations were calculated by Spearman's rank correlation coefficient (rho). Rasch analyses were used to test the internal construct of the BDL. The result from the BDL was compared to a healthy reference group. RESULTS: The correlation between the BDL and the BBS (rho = 0.703) was high positive, while for mUPDRS (rho = -0.280), TUG (rho = -0.321) and CTUG (rho = -0.361) the correlations with the BDL were negligible to low negative. The Rasch analyses for the BDL showed a good distribution of the task difficulties with neither ceiling nor floor effect among individual measures. There was a significant difference (p = 0.03) in performance of the BDL between the PD group and the healthy reference group. CONCLUSIONS: The BDL Balance Scale can be considered a valid clinical assessment test when evaluating balance training interventions in persons with early PD. It can be recommended as an outcome measure in clinical practice and in clinical research within this population.