Factors influencing activity performance and participation in usual life situations among people with Parkinson's disease: a mixed methods study.

Abstract

Multiple factors contribute to disability in persons with Parkinson's disease (PD). Understanding which factors most influence activity performance and participation in usual life situations may help clinicians develop personalised rehabilitation interventions. A triangulation mixed methods study was conducted using 137 people with PD; 13 were purposively sampled for semi-structured interviews. Two regression models examined the contributions of motor and non-motor impairments, activity limitations, personal and health factors to activities of daily living (ADL) performance and participation in usual life situations, respectively. Interviews probed participants' life experiences with PD. Motor and non-motor impairments, activity limitations, and PD duration explained 70% of the variance in ADL performance. Non-motor impairments, activity limitations, personal factors, and PD medications explained 54% of the variance in participation. Qualitative results revealed themes of "motivation to keep going" and "resilience to live well" in maintaining participation across a diverse range of life situations and highlighted the impacts of PD motor and non-motor impairments. Complex interactions were revealed among individuals' unique interests, life situations in which they participated, environments in which tasks were performed, willingness to make adaptations, impairment profile, and PD severity. Motor, non-motor, and contextual factors should be addressed in personalised intervention plans.