BACKGROUND: Although physical activity is beneficial for Parkinson's disease (PD) patients, many do not meet the recommended levels. The range of physical activity among sedentary PD patients is unknown, as are factors that determine this variability. Hence, we aimed to (1) assess daily physical activity in self-identified sedentary PD patients; (2) compare this with criteria of a daily physical activity guideline; and (3) identify determinants of daily physical activity. METHODS: Daily physical activity of 586 self-identified sedentary PD patients was measured with a tri-axial accelerometer for seven consecutive days. Physical fitness and demographic, disease-specific, and psychological characteristics were assessed. Daily physical activity was compared with the 30-min activity guideline. A linear mixed-effects model was estimated to identify determinants of daily physical activity. RESULTS: Accelerometer data of 467 patients who fulfilled all criteria revealed that >98% of their day was spent on sedentary to light-intensity activities. Eighty-two percent of the participants were 'physically inactive' (0 days/week of 30-min activity); 17% were 'semi-active' (1-4 days/week of 30-min activity). Age, gender, physical fitness, and scores on the Unified Parkinson's Disease Rating Scale explained 69% of the variability in daily physical activity. CONCLUSIONS: Performance-based measurements confirmed that most self-identified sedentary PD patients are 'physically inactive'. However, the variance in daily physical activity across subjects was considerable. Higher age, being female, and lower physical capacity were the most important determinants of reduced daily physical activity. Future therapeutic interventions should aim to improve daily physical activity in these high-risk patients, focusing specifically on modifiable risk factors.
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Dysarthritic Parkinson speech is characterised by impairment of expressive linguistic prosody, even making it difficult to understand. While rigidity and bradykinesia can be held responsible for a general decline in speaking ability, the origin of prosodic impairment must be seen in the light of the accompanying impairments of receptive prosody such as the inability to recognize intonational meaning and make lexical distinctions based on stress contrasts . The stimulating effect of music on motor coordination in afflicted patients suggests that music might have a similar effect on vocal behavior. It could be hypothesized that the singing of Parkinson patients might remain relatively unaffected by the disease. In this study, vocal improvisation was used to compare the singing of Parkinson patients with that of healthy controls, matched for age and gender. When F0 , range, mean absolute slope, and tempo were contrasted, Parkinson patients did not differ significantly from controls.
Parkinson’s disease is characterized not only by bradykinesia, rigidity, and tremor, but also by impairments of expressive and receptive linguistic prosody. The facilitating effect of music with a salient beat on patients’ gait suggests that it might have a similar effect on vocal behavior, however it is currently unknown whether singing is affected by the disease. In the present study, fifteen Parkinson patients were compared with fifteen healthy controls during the singing of familiar melodies and improvised melodic continuations. While patients’ speech could reliably be distinguished from that of healthy controls matched for age and gender, purely on the basis of aural perception, no significant differences in singing were observed, either in pitch, pitch range, pitch variability, and tempo, or in scale tone distribution, interval size or interval variability. The apparent dissociation of speech and singing in Parkinson’s disease suggests that music could be used to facilitate expressive linguistic prosody.
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