Award Date

5-15-2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Interdisciplinary Programs

First Committee Member

Merrill Landers

Second Committee Member

Brach Poston

Third Committee Member

James Navalta

Fourth Committee Member

Samantha John

Fifth Committee Member

Nirmala Lekhak

Number of Pages

270

Abstract

Parkinson’s disease (PD) is characterized by a wide range of non-motor symptoms that often affect the quality of life of persons with Parkinson’s disease (PwPD) even more profoundly than the motor symptoms typically associated with the condition. These non-motor symptoms include olfactory and gastrointestinal dysfunction, cognitive impairments, sleep disturbances, and psychological and social concerns. Psychosocial concerns include the mental, emotional, and social impact of PD on an individual’s functioning and, overall well-being. They reflect the interplay between symptoms of the disease, psychological development and functioning, personal relationships, and environmental factors. Mental health and psychosocial concerns such as depression, anxiety, fear of falling, fear-of-falling avoidance behavior, fear of disease progression, social isolation, and loneliness, are frequently under-recognized and overlooked by healthcare professionals, even when present at diagnosis. They may also go unreported by PwPD. These concerns meaningfully influence participation in physical therapy, exercise, and physical activity, thereby affecting rehabilitation outcomes. This dissertation aimed to examine the impact of mental health and psychosocial concerns on the psychosocial health and quality of life of PwPD, with the goal of informing more effective approaches to PD care. A scoping review was conducted to identify the mental health and psychosocial concerns commonly assessed by physical therapists (PTs), the assessment tools used, the interventions employed to address these concerns, and PTs’ referral practices (Chapter 1). To further explore the prevalence and impact of these concerns, a study was conducted to capture the perspectives of PwPD, including their confidence in exercise as a means of improving psychosocial health (Chapter 2). Chapter 3 examined how these concerns influence physical activity levels, providing insight into their contribution to physical inactivity among PwPD. Finally, Chapter 4 explored the perspectives of PTs, who are core to PD rehabilitation, to understand their knowledge, attitudes, practice approaches, referral behaviors, and perceived barriers related to addressing these concerns. Overall, the findings of this dissertation offer a comprehensive understanding of how mental health and psychosocial concerns influence functioning, participation, and quality of life in PD. They also highlight opportunities for developing targeted interventions and community-based programs. Future research is needed to evaluate the effectiveness of PT-led interventions designed to address these concerns, as well as the impact of training PTs in competencies related to mental health and psychosocial care for PwPD. Additionally, future studies should establish temporal precedence between reduced exercise/physical activity and mental health/psychosocial concerns to determine which changes occur first. Understanding this sequence may help clinicians identify optimal intervention time points and tailor strategies to maximize both physical and psychosocial benefits.

Keywords

Exercise/Physical Activity; Mental Health; Neurorehabilitation; Parkinson's Disease; Physical Therapy; Psychosocial Factors/concerns

Disciplines

Family, Life Course, and Society | Geriatrics | Medicine and Health Sciences | Physical Therapy | Physiotherapy

File Format

PDF

File Size

1919 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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