Impact of a 7-day retreat for people with Parkinson's disease: a phenomenological study
Abstract
Aim: Early and ongoing access to rehabilitation and exercise may preserve functional mobility and quality of life for persons with Parkinson disease (PwP). The aim of the current study was to describe the experience of PwP who participated in a 7-day retreat. Materials & methods: A phenomenological approach was used to describe the lived experience of PwP. Results: Three themes emerged from interviews: a community of shared information where participants discussed exercising and learning with other PwP; improved control of Parkinson's disease symptoms, including performing physical tasks more easily and renewed motivation for their long-term plans for exercise because of the retreat. Conclusion: A 7-day retreat for PwP positively impacted perceived control of disease-related symptoms and intentions to continue exercise.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1. . The emerging evidence of the Parkinson pandemic. J. Parkinsons Dis. 8(s1), S3–S8 (2018).
- 2. . Parkinson's disease primer, part 2: management of motor and nonmotor symptoms. Can. Fam. Physician 69(2), 91–96 (2023).
- 3. . Aerobic exercise: evidence for a direct brain effect to slow Parkinson's disease progression. Mayo Clin. Proc. 93(3), 360–372 (2018).
- 4. Effects of group, individual, and home exercise in persons with Parkinson's disease: a randomized clinical trial. J. Neurol. Phys. Ther. 39(4), 204–212 (2015).
- 5. . Long-term effects of exercise and physical therapy in people with Parkinson's disease. Nat. Rev. Neurol. 13(11), 689–703 (2017). • A review on the long-term effects of exercise and physical therapy, suggesting that at least 6 months of training is associated with clinically meaningful improvement on functional rating of disease.
- 6. Physical therapist management of Parkinson's disease: a clinical practice guideline from the American Physical Therapy Association. Phys. Ther. 102(4), 1–36 (2022). • A guideline for physical therapist management of Parkinson's disease, indicating rehabilitation and exercise can decrease symptoms, preserve functional mobilityand improve quality of life.
- 7. . The effectiveness of physiotherapy treatment on balance dysfunction and postural instability in persons with Parkinson's disease: a systematic review and meta-analysis. BMC Sports Sci. Med. Rehabil. 8, 17 (2016).
- 8. . Effects of exercise therapy on postural instability in Parkinson's disease: a meta-analysis. J. Neurol. Phys. Ther. 40(1), 3–14 (2016).
- 9. . Parkinson's disease and intensive exercise therapy: a systematic review and meta-analysis of randomized controlled trials. J. Neurol. Sci. 353(1-2), 9–19 (2015).
- 10. . A physical therapy decision-making tool for stratifying persons with Parkinson's disease into community exercise classes. Neurodegener. Dis. Manag. 9(6), 331–346 (2019). • A retrospective study of records from 4 years of physical therapy evaluations and attendance in community-based exercise classes, describing the PWR!Exercise4BrainChange® approach.
- 11. . Intensive amplitude-specific therapeutic approaches for Parkinson's disease: toward a neuroplasticity-principled rehabilitation model. Top. Geriatr. Rehabil. 24(2), 99–114 (2008). • A seminal article on the benefit of large-amplitude movement for management of Parkinson's disease.
- 12. . Lee Silverman Voice Treatment (LSVT)-BIG to improve motor function in people with Parkinson's disease: a systematic review and meta-analysis. Clin. Rehabil. 32(5), 607–618 (2018).
- 13. . The health impact of residential retreats: a systematic review. BMC Complement. Altern. Med. 18, 8 (2018). •• A review of 23 studies of mostly healthy participants and some with chronic diseases, suggesting health benefits from residential retreat experiences.
- 14. Intensive rehabilitation treatment in early Parkinson's disease: a randomized pilot study with a 2-year follow-up. Neurorehabil. Neural Repair 29(2), 123–131 (2015). • A report indicating that 4-week intensive residential rehab treatment with individual format resulted in improved physical functioning.
- 15. . Towards proactive active living: patients with Parkinson's disease experience of a multidisciplinary intensive rehabilitation treatment. Eur. J. Phys. Rehabil. Med. 53(1), 114–124 (2017). • A qualitative study with the same 4-week treatment as in ref. [14], reporting participants recognized the importance of an active lifestyle with intension to continue on their own.
- 16. . Effects of a group protocol on physical activity and associated changes in mood and health locus of control in adults with Parkinson's disease and reduced mobility. Perm. J. 23, 18–128 (2019).
- 17. . Experiences of people with Parkinson's disease and their views on physical activity interventions: a qualitative systematic review. JBI Database System Rev. Implement Rep. 17(4), 548–613 (2019).
- 18. . Descriptive versus interpretive phenomenology: their contributions to nursing knowledge. Qual. Health Res. 14(5), 726–735 (2004).
- 19. . Video-conferencing interviews in qualitative research. In: Enhancing Qualitative and Mixed Methods Research with Technology. Hai-Jew S (Ed.). 140–157 IGI Global, PA, USA (2015).
- 20. . Qualitative Research & Evaluation: Integrating Theory and Practice (4th Edition). SAGE Publications, CA, USA (2015).
- 21. . Interviewing the investigator: strategies for addressing instrumentation and researcher bias concerns in qualitative research. Qual. Rep. 16(1), 255–262 (2011).
- 22. . Conducting qualitative data analysis: reading line-by-line, but analyzing by meaningful qualitative units. Qual. Rep. 17(1), 266–269 (2012).
- 23. . The Coding Manual for Qualitative Researchers. SAGE Publications, CA, USA (2021).
- 24. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol. Health 25(10), 1229–1245 (2010).
- 25. . Naturalistic Inquiry. SAGE Publications, CA, USA (1985).
- 26. . Qualitative Inquiry and Research Design: Choosing Among Five Approaches (4th Edition). SAGE Publications, CA, USA (2018).
- 27. Health-related quality of life outcomes at 1 and 5 years after a residential retreat promoting lifestyle modification for people with multiple sclerosis. Neurol. Sci. 34(2), 187–195 (2013).
- 28. . Effect of a residential retreat promoting lifestyle modifications on health-related quality of life in people with multiple sclerosis. Qual. Prim. Care 18(6), 379–389 (2010).
- 29. . Being limited by Parkinson's disease and struggling to keep up exercising: is the group the glue? Disabil. Rehabil. 42(9), 1270–1274 (2020). • A qualitative study indicates that the attitudes and experiences of persons with Parkinson's disease (PwP) who participated in a community-based exercise class added a positive social aspect and improved coping with their disease.
- 30. . Effects of a community-based exercise program on mobility, balance, cognition, sleep, activities of daily living, and quality of life in PD: a pilot study. Neurodegener. Dis. Manag. 10(1), 27–39 (2020).
- 31. Barriers and motivators to engage in exercise for persons with Parkinson's disease. J. Parkinsons Dis. 10(4), 1293–1299 (2020). •• A comprehensive review of the barriers and motivators to begin and to remain engaged in exercise for PwP, organized in the International Classification of Functioning, Disability, and Health framework.
- 32. . Social comparisons, social support, and self-perceptions in group exercise for people with Parkinson's disease. J. Appl. Sport Psychol. 29(3), 285–303 (2017).
- 33. . A qualitative examination of apathy and physical activity in Huntington's and Parkinson's disease. Neurodegener. Dis. Manag. 12(3), 129–139 (2022).
- 34. . Motivators and barriers to exercise in Parkinson's disease. J. Parkinsons Dis. 7(4), 703–711 (2017).
- 35. . Sedentary behavior and quality of life in individuals with Parkinson's disease. Neurorehabil. Neural Repair 33(8), 595–601 (2019).
- 36. . Self-efficacy: toward a unifying theory of behavioral change. Psychol. Rev. 84(2), 191–215 (1977).
- 37. . Determinants of self-efficacy in patients with Parkinson's disease. Arq. Neuropsiquiatr. 79(8), 686–691 (2021).
- 38. . Helping people with Parkinson's disease build exercise self-efficacy. Phys. Ther. 100(2), 205–208 (2020). •• A perspectives paper with a list of recommended principles and specific suggestions for exercise specialists to consider when working with PwP.
- 39. . Doing interviews. SAGE Publications, Ltd, London, UK (2007). https://doi.org/10.4135/9781849208963
- 40. . Qualitative Research: A Personal Skills Approach (2nd Edition). Pearson Education, (2005).
- 41. . Interpretive Phenomenological Analysis: Theory, Method and Research (2nd Edition). SAGE Publications, Ltd, London, UK (2022).
- 42. . Biopsychosocial model of illnesses in primary care: a hermeneutic literature review. J. Family Med. Prim. Care 7(3), 497–500 (2018).