Self-Efficacy Ingredients for Success: A Mixed-Methods Study Addressing Nonmotor Symptoms and Quality of Life in Parkinson’s Disease

Background: Parkinson’s Disease (PD) exerts both motor and nonmotor symptoms that collectively reduce quality of life. While motor impairments are often the focus of clinical management, nonmotor symptoms such as depression, anxiety, cognitive decline, and low self-efficacy significantly contribute to decreased motivation, sedentary behavior, and diminished well-being. Addressing these multifactorial symptoms is essential to improving meaningful health outcomes and overall life satisfaction for individuals with Parkinson’s Disease. Purpose: This single subject design withdrawal design mixed-methods study aims to examine how a supportive walking intervention can enhance confidence, promote engagement in physical activity, and improve overall functional mobility for individuals with Parkinson’s Disease. Methods: Five participants with PD participated in an intensity-based walking intervention program provided in an environment with opportunities to improve self-efficacy and quality of life. PDQ-39 and Activities of balance confidence scores were obtained pre and post intervention study to assess both quality of life and mobility confidence. In addition, phenomenology qualitative semi structured interviews were completed and thematic analysis was conducted to understand the impact of the intervention on nonmotor symptoms to PD after participating in the intervention program. Results: All 5 participants demonstrated improved scores on both the PDQ and ABC, with at least 3 out of 5 participants reaching published and established minimal detectable changes within this population. Thematic analysis revealed four emerging themes common across the 5 participants which included overcoming fear, accountability, improvement, and confidence. Conclusion: Our findings support the use of interventions in a structured environment that provides opportunities to improve quality of life, confidence and self-efficacy. Choosing an environment that enhancing self-efficacy may represent a critical strategy for improving both motor and nonmotor outcomes in PD. These findings may also help inform future rehabilitation approaches aimed at promoting independence and improving overall quality of life in this population