‘Mind the gap’ — a scoping review of long term, physical, self-management in Parkinson’s

BACKGROUND:Parkinson's is a common progressive neurological condition characterised by impairments of movement and balance; and non-motor deficits. It is now accepted that physical activity is a fundamental for people with Parkinson's (PwP), despite this PwP remain inactive. There is a social and financial drive to increase physical activity for PwP through physical self-management, however little is known about this concept. OBJECTIVE:This scoping review provides an overview of the literature concerning physical self-management for PwP and its provision, participation and uptake by PwP. DESIGN AND SOURCES OF EVIDENCE:Systematic search of the databases; Medline, EMBASE, HMIC, CDSR, Cochrane Methods Studies, DARE, CINAHL, PEDro, PsycINFO and Cochrane Library using the search terms 'Parkinson*' and 'self-manag*' was undertaken alongside citation and grey literature searching and a consultation exercise. CHARTING METHODS:A narrative summary was undertaken to describe the current state of the literature. RESULTS:1959 studies were identified with nineteen papers from seventeen studies meeting the inclusion criteria - Three reviews, four experimental studies, three pre-post-test designs, six cross-sectional designs, one qualitative interview design and two mixed method designs. CONCLUSION:The findings of this scoping review suggest a need for clarity on what 'physical self-management' means and involves, with a gap between what the evidence promotes and what is being achieved by PwP. Further research should focus on the amount, type, intensity and duration of physical self-management models including behavioural change approaches and how, where and by whom this should be implemented.