Psychosocial determinants of exercise behavior in Parkinson's disease: a mini-review

Parkinson's disease (PD) is the second most common neurodegenerative disorder, characterized by progressive motor and non-motor symptoms that profoundly impact quality of life. Physical exercise has emerged as a promising non-pharmacological intervention with neuroprotective potential, yet adherence rates remain suboptimal. This mini-review synthesizes current evidence on psychosocial determinants influencing exercise behavior in PD patients. Accumulating evidence suggests that psychosocial factors play an important role on exercise engagement, such as self-efficacy, social support, depression, apathy, perceived control, coping, and psychological resilience. Self-efficacy emerges as the most robust predictor across studies. Individuals who reported high exercise self-efficacy were more likely to engage in regular exercise regardless of disease severity. Social support from family, peers, and healthcare professionals could enhance the motivation, accountability, and adherence of exercise behavior. Depression and apathy significantly undermine exercise participation. Higher perceived control, active coping, and higher psychological resilience are associated with greater exercise engagement. This mini-review critically evaluated the evidence for these key psychosocial determinants in PD patients and proposed a clinically-informed framework for integrating psychosocial strategies into exercise promotion.