Abstract
The study is a descriptive research design analyzing correlations between HDRS scores and self-reported physical activity levels. The purpose is to determine the possible relationship between self-reported physical activity and depression in individuals with Parkinson’s disease. The results can influence the field of OT by informing practice to consider tracking activity and participation to help combat depression with Parkinson’s disease.
Primary Author and Speaker: Kaitlyn Landess
Additional Authors and Speakers: Cindy Ivy
Contributing Authors: Linda Denney, Michelle McKay
This study analyzes how physical activity levels correlate to depression scores in people with Parkinson’s disease (PD). The data used in this paper is based off of a clinical study by the same authors that suggests people with PD who engaged in 6 weeks of boxing had lower Hamilton Depression Rating Scale (HDRS) scores from pre-boxing to post-boxing, indicating that high intensity exercise may impact levels of depression symptoms in people with PD (Denney et al., 2019). Wu, Lee, and Huang (2017) found that physical activity, especially aerobic exercise, qigong and balance training, can decrease the presence of depressive symptoms in individuals with PD and improve overall quality of life. The purpose of the study is to determine if the HDRS scores are correlated with self-reported physical activity levels during the 6 weeks post-boxing training. The hypothesis is that individuals with lower HDRS scores following the boxing study will have higher self-reported activity levels. Through analysis of HDRS scores, researchers will gain insight into the impact depressive symptoms have on physical activity, providing further clinical understanding of the impact depression symptoms may have on engagement in physical activity. The study is a descriptive research design to identify the relationship between depression and self-reported physical activity using repeated measures of HDRS and data analysis of the activity logs. The HDRS is a 17-item self-report scale used to record depression symptoms. The HDRS was administered to 12 individuals (8 male, 4 female) diagnosed 1-16 years ago with PD (Hoehn & Yahr I-III) at week 7, following the 6 week boxing intervention. A follow-up HDRS was administered at week 13. The worksheet headings were: the type of activity completed, the duration of the activity and level of intensity (low, moderate, high) for each day of the week, for 6 weeks. A Pearson correlation was used to determine if there was a correlation between the percent of self-reported low, moderate, and high exercise intensity and HDRS scores between weeks 6 and 12. Participants who reported activity at a high intensity had lower HDRS scores demonstrating a moderate inverse correlation (r = -0.45). Therefore, those that had a high number of recorded hours for high intensity activity, had lower depression scores. Those that reported a low or moderate intensity activity had a weak correlation to HDRS scores (r = 0.34, r = -0.01 respectively). The results indicate that high intensity activity has a moderate correlation with a decrease in depression scores indicating that an increase in high intensity activity may decrease HDRS scores. The limitations of this study include the small sample size of 12 participants which limits the generalizability of the results to the population. The self-report worksheet may influence motivation for physical activity and could be considered a mechanism to promote activity in individuals with PD. From these results clinicians may gain insight into the impact that high intensity physical activity can have on HDRS scores in individuals with PD and encourage clinicians to integrate higher intensity activities into their interventions. The possible biases of this study include: sampling bias due to the participants of the study choosing to participate in the intervention group; recall bias due to self reported aspect of the workout logs and the self-reported ratings on the HDRS; and intervention bias due to the short duration of the study. Further research should be conducted to determine the correlation between multiple depression scales and intensity of physical activity completed. Researchers could also specify the types of physical activity and controlled dosing of activity for greater specificity of results.
Denney, L.M., Ivy, C.C., McKay, M., Manning, J., Landess, K., Webster, M., Urrutia, M., & Pohl, P.S. (2019). Does boxing improve sleep quality and daytime sleepiness in individuals with Parkinson’s Disease? Unpublished raw data.
Wu, P., Lee, M., Huang, T. (2017). Effectiveness of physical activity on patients with depression and Parkinson’s disease: A systematic review. PLoS ONE, 12(7), e0181515. DOI:10.1371/journal.pone.0181515