The inter-relationship between various non-motor symptoms and with habitual physical activity in Parkinsonism: a scoping review protocol

Abstract Background Over 90% of individuals with neurodegenerative Parkinsonism present with non-motor symptoms (NMS), which have a significantly negative impact on their quality of life (QoL) more so than motor symptoms. Currently, NMS remain under-appreciated and under-researched compared to motor symptoms. This contributes to a limited understanding of the inter-relationship between various NMS (i.e. symptom-to-symptom interaction) and the scarcity of effective evidence-based treatment strategies. Physical activity (PA) and exercise are promising therapeutic options, but many people with Parkinsonism are inactive. Currently, there appears to be a limited understanding of the relationship between PA and NMS in this population. Objective This proposed review aims to explore and synthesise what is currently known about (1) the inter-relationship between various NMS and (2) their relationship with habitual PA among adults with neurodegenerative Parkinsonism. This review will also highlight potential research gaps in the literature. Methods Two independent scoping reviews will be completed to address the two distinct objectives. The reviews will follow recommended methodological and reporting guidelines. Conclusion Understanding the inter-relationship between various NMS and their relationship with PA behaviour might help guide which NMS to target therapeutically and help develop effective evidence-based PA recommendations that are feasible for people with neurodegenerative Parkinsonism.