Exploring social, cultural and environmental factors that influence attitudes to exercise among people with Parkinson's disease: A qualitative study.

Exercise is recommended for people with Parkinson's (PwP) but clinical exercise-based interventions are generally ineffective. Social, cultural and environmental factors can influence exercise behaviours, but these topics are under-researched. We interviewed 18 PwP using a narrative approach to identify factors influencing their exercise behaviours throughout their lives. Thematic analysis identified three themes: (1) Why I exercise, (2) What helps and (3) Exercise with Parkinson's. Participants had consistent core motivations to exercise: mood and well-being, body image, competition, and camaraderie. Having active partners, supportive work, and varied exercise options were among the important facilitators of long-term exercise. Participants believed strongly in the benefits of exercise for Parkinson's, but experienced guilt about not exercising enough and frustration when symptoms made it harder to continue. This study illustrates how narrative interviews can reveal important social, cultural and environmental influences on exercise behaviour, offering potential to develop more individualised and effective exercise interventions.