Objective: This project aimed to characterize community ambulatory activity behaviors of people with PD across motor disease severity and characterize the influence of non-motor symptoms on daily steps.
Background: Multi-day ambulatory activity measures capture progressing gait-related disability not readily apparent in clinical measures of gait or disease severity, however the influence of factors such as motor severity and non-motor symptoms on ambulatory activity have not been well studied. This project aimed to characterize community ambulatory activity behaviors of people with PD across motor disease severity and to examine non-motor symptoms’ influence on daily steps.
Method: Participants with mild to moderate PD enrolled in a multi-site exercise trial were provided a wearable activity monitor to capture the mean number of daily steps. Motor disease severity (on and off medications) and self-report of non-motor symptoms were gathered using the Movement Disorders Society – Unified Parkinson Disease Rating Scale Part III and Part I, respectively. Simple and multiple linear regressions were used to model the association of motor signs and non-motor symptoms and ambulatory activity, controlling for age, race, BMI and depression. To examine the effects of motor disease severity on overall step accumulation, we created cross-sectional quartiles of motor severity based on for Movement Disorders Society – Unified Parkinson Disease Rating Scale III off-medication scores.
Results: Median step count was 5180 (3532-7200) for 198 individuals with PD. Increasing motor disease severity was associated with a decrease in ambulatory activity. Off medication MDS-UPDRS III scores, but not on-medication scores, predicted ambulatory activity (p<0.05). For non-motor symptoms, only self-reported symptoms of cardiovascular autonomic dysfunction were associated with a significant reduction of daily steps compared to no reports of symptoms (p<0.05).
Conclusion: Greater motor disease severity was associated with fewer daily steps and participants with PD regulated their daily ambulation level based on their off-medication motor disease severity. Non-motor symptoms, specifically complaints of dizziness or lightheadedness influenced daily ambulatory activity. Individuals with PD demonstrated daily step amounts that, as a group, did not meet recommended daily physical activity levels.
References: Christiansen C, Moore C, Schenkman M, et al. Factors Associated With Ambulatory Activity in De Novo Parkinson Disease. Journal of Neurologic Physical Therapy. 2017;41(2):93-100. doi:10.1097/npt.0000000000000169
Cavanaugh JT, Ellis TD, Earhart GM, Ford MP, Foreman KB, Dibble LE. Toward Understanding Ambulatory Activity Decline in Parkinson Disease. Phys Ther. Aug 2015;95(8):1142-50. doi:10.2522/ptj.20140498
Cavanaugh JT, Ellis TD, Earhart GM, Ford MP, Foreman KB, Dibble LE. Capturing ambulatory activity decline in Parkinson’s disease. J Neurol Phys Ther. Jun 2012;36(2):51-7. doi:10.1097/NPT.0b013e318254ba7a
Correno MB, Hansen C, Carlin T, Vuillerme N. Objective Measurement of Walking Activity Using Wearable Technologies in People with Parkinson Disease: A Systematic Review. Sensors. 2022-06-16 2022;22(12):4551. doi:10.3390/s22124551
Hechtner MC, Vogt T, Zöllner Y, et al. Quality of life in Parkinson’s disease patients with motor fluctuations and dyskinesias in five European countries. Parkinsonism Relat Disord. Sep 2014;20(9):969-74. doi:10.1016/j.parkreldis.2014.06.001
Curtze C, Nutt JG, Carlson-Kuhta P, Mancini M, Horak FB. Objective Gait and Balance Impairments Relate to Balance Confidence and Perceived Mobility in People With Parkinson Disease. Physical Therapy. 2016-11-01 2016;96(11):1734-1743. doi:10.2522/ptj.20150662
Bloem BR, Okun MS, Klein C. Parkinson’s disease. Lancet. Jun 12 2021;397(10291):2284-2303. doi:10.1016/s0140-6736(21)00218-x
Rodriguez‐Blazquez C, Schrag A, Rizos A, Chaudhuri KR, Martinez‐Martin P, Weintraub D. Prevalence of Non‐Motor Symptoms and Non‐Motor Fluctuations in Parkinson’s Disease Using the
Khan A, Ezeugwa J, Ezeugwu VE. A systematic review of the associations between sedentary behavior, physical inactivity, and non-motor symptoms of Parkinson’s disease. PLOS ONE. Mar 29, 2024;19(3)doi:10.1371/journal.pone.0293382
Alberts JL, Rosenfeldt AB, Lopez-Lennon C, et al. Effectiveness of a Long-Term, Home-Based Aerobic Exercise Intervention on Slowing the Progression of Parkinson Disease: Design of the Cyclical Lower Extremity Exercise for Parkinson Disease II (CYCLE-II) Study. Phys Ther. Nov 1 2021;101(11)doi:10.1093/ptj/pzab191
To cite this abstract in AMA style:
C. Lopez-Lennon, J. Hale, E. Suttman, A. Rosenfeldt, A. Jansen, J. Alberts, L. Dibble. The Association of Motor and Non-motor Factors on Ambulatory Activity in People with Parkinson disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/the-association-of-motor-and-non-motor-factors-on-ambulatory-activity-in-people-with-parkinson-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-association-of-motor-and-non-motor-factors-on-ambulatory-activity-in-people-with-parkinson-disease/