{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:00Z","timestamp":1788415980176,"version":"build-2803163510"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Parkinson\u2019s 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.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1942675","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:18:16Z","timestamp":1788412696000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychosocial determinants of exercise behavior in Parkinson\u2019s disease: a mini-review"],"prefix":"10.3389","volume":"14","author":[{"given":"Guanyu","family":"Zhang","sequence":"first","affiliation":[{"name":"China Institute of Sport Science","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson\u2019s disease, 1990-2016: a systematic analysis for the global burden of disease study 2016","volume":"17","year":"2016","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","article-title":"Parkinson\u2019s disease","volume":"397","author":"Bloem","year":"2021","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1002\/mds.26352","article-title":"Advances in the treatment of cognitive impairment in Parkinson\u2019s disease","volume":"30","author":"Goldman","year":"2015","journal-title":"Mov Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1001\/jama.2014.3654","article-title":"Pharmacological treatment of Parkinson disease: a review","volume":"311","author":"Connolly","year":"2014","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1038\/s41582-018-0128-2","article-title":"Deep brain stimulation: current challenges and future directions","volume":"15","author":"Lozano","year":"2019","journal-title":"Nat Rev Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5895","DOI":"10.3390\/ijms21165895","article-title":"Possible neuroprotective mechanisms of physical exercise in neurodegeneration","volume":"21","author":"Mahalakshmi","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1002\/mds.21922","article-title":"The effectiveness of exercise interventions for people with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"23","author":"Goodwin","year":"2008","journal-title":"Mov Disord"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2047-9158-3-5","article-title":"The effects of exercise on cognition in Parkinson\u2019s disease: a systematic review","volume":"3","author":"Murray","year":"2014","journal-title":"Transl Neurodegener"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"792","DOI":"10.3390\/brainsci15080792","article-title":"Effects of aerobic exercise on depressive symptoms in people with Parkinson\u2019s disease: a systematic review and Meta-analysis of randomized controlled trials","volume":"15","author":"Ren","year":"2025","journal-title":"Brain Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"38","DOI":"10.3390\/jfmk7020038","article-title":"Physical exercise and health: a focus on its protective role in neurodegenerative diseases","volume":"7","author":"Bonanni","year":"2022","journal-title":"J Funct Morphol Kinesiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1177\/1545968313508474","article-title":"Intensive rehabilitation increases BDNF serum levels in parkinsonian patients","volume":"28","author":"Frazzitta","year":"2014","journal-title":"Neurorehabil Neural Repair"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.2522\/ptj.20140374","article-title":"Levels and patterns of physical activity and sedentary behavior in elderly people with mild to moderate Parkinson disease","volume":"95","author":"Benka Wallen","year":"2015","journal-title":"Phys Ther"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4236\/psych.2015.61005","article-title":"Enjoyment during exercise mediates the effects of an intervention on exercise adherence","volume":"6","author":"Jekauc","year":"2015","journal-title":"Psychology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1136\/jnnp.72.2.241","article-title":"Health related quality of life in Parkinson\u2019s disease: a systematic review of disease specific instruments","volume":"72","author":"Marinus","year":"2002","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2020\/8961493","article-title":"Exercise-induced neuroplasticity in Parkinson\u2019s disease: a metasynthesis of the literature","volume":"2020","author":"Johansson","year":"2020","journal-title":"Neural Plast"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.2522\/ptj.20100390","article-title":"Factors associated with exercise behavior in people with Parkinson disease","volume":"91","author":"Ellis","year":"2011","journal-title":"Phys Ther"},{"key":"ref17","volume-title":"Self-Efficacy: The Exercise of Control","author":"Bandura","year":"1997"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1123\/japa.17.1.1","article-title":"Exercise self-efficacy and control beliefs: effects on exercise behavior after an exercise intervention for older adults","volume":"17","author":"Neupert","year":"2009","journal-title":"J Aging Phys Act"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"703","DOI":"10.3233\/JPD-171173","article-title":"Motivators and barriers to exercise in Parkinson\u2019s disease","volume":"7","author":"Afshari","year":"2017","journal-title":"J Parkinsons Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1177\/1524839904266792","article-title":"A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II)","volume":"6","author":"Marks","year":"2005","journal-title":"Health Promot Pract"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12966-017-0509-8","article-title":"The association between social support and physical activity in older adults: a systematic review","volume":"14","author":"Lindsay Smith","year":"2017","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1111\/bjhp.12139","article-title":"Received social support and exercising: an intervention study to test the enabling hypothesis","volume":"20","author":"Rackow","year":"2015","journal-title":"Br J Health Psychol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1177\/0022146510395592","article-title":"Mechanisms linking social ties and support to physical and mental health","volume":"52","author":"Thoits","year":"2011","journal-title":"J Health Soc Behav"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1177\/1359105309342297","article-title":"Social cognitive mediators of change in a group randomized nutrition and physical activity intervention: social support, self-efficacy, outcome expectations and self-regulation in the guide-to-health trial","volume":"15","author":"Anderson","year":"2010","journal-title":"J Health Psychol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1111\/j.1745-6924.2009.01141.x","article-title":"Can we improve our physical health by altering our social networks?","volume":"4","author":"Cohen","year":"2009","journal-title":"Perspect Psychol Sci"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1093\/gerona\/56.suppl_2.36","article-title":"Interventions to promote physical activity by older adults","volume":"56","author":"King","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"pzaf048","DOI":"10.1093\/ptj\/pzaf048","article-title":"Motivation matters: elucidating factors driving exercise in people with Parkinson disease","volume":"105","author":"Cools","year":"2025","journal-title":"Phys Ther"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1177\/02692155221100884","article-title":"Exercising with Parkinson\u2019s: the good, the bad and the need for support to keep exercising. A qualitative study","volume":"36","author":"Flynn","year":"2022","journal-title":"Clin Rehabil"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1080\/09638280902850261","article-title":"Social support for physical activity and perceptions of control in early Parkinson\u2019s disease","volume":"31","author":"Ravene","year":"2009","journal-title":"Disabil Rehabil"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s11910-013-0409-5","article-title":"Depression and Parkinson\u2019s disease: current knowledge","volume":"13","author":"Marsh","year":"2013","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1007\/s40266-022-00942-1","article-title":"Depression in patients with Parkinson\u2019s disease: current understanding of its neurobiology and implications for treatment","volume":"39","author":"Prange","year":"2022","journal-title":"Drugs Aging"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1176\/appi.ajp.2018.17111194","article-title":"Physical activity and incident depression: a meta-analysis of prospective cohort studies","volume":"175","author":"Schuch","year":"2018","journal-title":"Am J Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1002\/mds.26208","article-title":"Apathy in Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"30","author":"den Brok","year":"2015","journal-title":"Mov Disord"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3109\/09638288.2014.939771","article-title":"Experiences of apathy in people with Parkinson\u2019s disease: a qualitative exploration","volume":"37","author":"Simpson","year":"2015","journal-title":"Disabil Rehabil"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e12505","DOI":"10.1002\/dad2.12505","article-title":"Apathy as a determinant of health behaviors in older adults: implications for dementia risk reduction","volume":"15","author":"Harrison","year":"2023","journal-title":"Alzheimers Dement Diagn Assess Dis Monit"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1177\/1359105314554818","article-title":"Perceived control and self-efficacy, subjective well-being and lifestyle behaviours in young Iranian women","volume":"21","author":"Salehi","year":"2016","journal-title":"J Health Psychol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.3109\/09638288.2010.525287","article-title":"A review of the demographic, clinical and psychosocial correlates of perceived control in three chronic motor illnesses","volume":"33","author":"Eccles","year":"2011","journal-title":"Disabil Rehabil"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"116841","DOI":"10.1016\/j.jns.2020.116841","article-title":"Does perceived control mediate the relationship between stigma and well-being for individuals with Parkinson\u2019s disease?","volume":"414","author":"Verity","year":"2020","journal-title":"J Neurol Sci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1037\/hea0001153","article-title":"Perceived behavioral control moderating effects in the theory of planned behavior: a meta-analysis","volume":"41","author":"Hagger","year":"2022","journal-title":"Health Psychol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s40519-018-0504-3","article-title":"Obligatory exercise and coping in treatment-seeking women with poor body image","volume":"23","author":"Serier","year":"2018","journal-title":"Eat Weight Disord"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1037\/0003-066X.54.7.493","article-title":"Implementation intentions: strong effects of simple plans","volume":"54","author":"Gollwitzer","year":"1999","journal-title":"Am Psychol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1093\/arclin\/acz063","article-title":"Literature review: psychological resilience factors in people with neurodegenerative diseases","volume":"36","author":"Ovaska-Stafford","year":"2021","journal-title":"Arch Clin Neuropsychol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.parkreldis.2011.09.021","article-title":"What determines resilience in patients with Parkinson\u2019s disease?","volume":"18","author":"Robottom","year":"2012","journal-title":"Parkinsonism Relat Disord"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"3004","DOI":"10.1177\/1359105315588758","article-title":"The roles of resilience and nonmotor symptoms in adjustment to Parkinson\u2019s disease","volume":"21","author":"Shamaskin-Garroway","year":"2016","journal-title":"J Health Psychol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3109\/09638288.2016.1138556","article-title":"Bouncing back again, and again: a qualitative study of resilience in people with multiple sclerosis","volume":"39","author":"Silverman","year":"2017","journal-title":"Disabil Rehabil"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1474579","DOI":"10.3389\/fpsyg.2025.1474579","article-title":"The underlying mechanism of physical exercise on neurodegenerative diseases: the mediating role of psychological stress and resilience: a systematic review","volume":"16","author":"Jiang","year":"2025","journal-title":"Front Psychol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1080\/13548506.2011.564189","article-title":"Why are some people with neurological illness more resilient than others?","volume":"17","author":"McCabe","year":"2012","journal-title":"Psychol Health Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.3233\/JPD-202247","article-title":"Barriers and motivators to engage in exercise for persons with Parkinson\u2019s disease","volume":"10","author":"Schootemeijer","year":"2020","journal-title":"J Parkinsons Dis"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.jadohealth.2007.10.005","article-title":"Sex differences in exercise behavior during adolescence: is biological maturation a confounding factor?","volume":"42","author":"Cumming","year":"2008","journal-title":"J Adolesc Health"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"igy007","DOI":"10.1093\/geroni\/igy007","article-title":"When adults don\u2019t exercise: behavioral strategies to increase physical activity in sedentary middle-aged and older adults","volume":"2","author":"Lachman","year":"2018","journal-title":"Innov Aging"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1093\/hsw\/hlv044","article-title":"Modeling active aging and explicit memory: an empirical study","volume":"40","author":"Ponce de Le\u00f3n","year":"2015","journal-title":"Health Soc Work"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1002\/mds.22940","article-title":"Self-management rehabilitation and health-related quality of life in Parkinson's disease: a randomized controlled trial","volume":"25","author":"Tickle-Degnen","year":"2010","journal-title":"Mov Disord"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.ypmed.2009.07.007","article-title":"Why and how to improve physical activity promotion: lessons from behavioral science and related fields","volume":"49","author":"King","year":"2009","journal-title":"Prev Med"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1093\/fampra\/cmac004","article-title":"The benefits and challenges of established peer support programmes for patients, informal caregivers, and healthcare providers","volume":"39","author":"Joo","year":"2022","journal-title":"Fam Pract"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.pec.2007.06.002","article-title":"Social support in cyberspace: a content analysis of communication within a Huntington\u2019s disease online support group","volume":"68","author":"Coulson","year":"2007","journal-title":"Patient Educ Couns"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3233\/JHD-180293","article-title":"Clinical management of neuropsychiatric symptoms of Huntington disease: expert-based consensus guidelines on agitation, anxiety, apathy, psychosis and sleep disorders","volume":"7","author":"Anderson","year":"2018","journal-title":"J Huntingtons Dis"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/0022-3956(82)90033-4","article-title":"Development and validation of a geriatric depression screening scale: a preliminary report","volume":"17","author":"Yesavage","year":"","journal-title":"J Psychiatr Res"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1038\/nrneurol.2011.60","article-title":"Depression and risk of developing dementia","volume":"7","author":"Byers","year":"2011","journal-title":"Nat Rev Neurol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1080\/13607863.2025.2464712","article-title":"Brief behavioral activation therapy is effective on apathy symptoms of the older adults with mild Alzheimer\u2019s disease but not with moderate Alzheimer\u2019s disease","volume":"29","author":"Karimpourvazifehkhorani","year":"2025","journal-title":"Aging Ment Health"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/00005650-199901000-00003","article-title":"Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial","volume":"37","author":"Lorig","year":"1999","journal-title":"Med Care"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.3233\/JPD-201999","article-title":"Happiness: a novel outcome in Parkinson studies?","volume":"10","author":"Cools","year":"2020","journal-title":"J Parkinsons Dis"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1037\/rep0000167","article-title":"Pilot evaluation of a resilience training program for people with multiple sclerosis","volume":"63","author":"Pakenham","year":"2018","journal-title":"Rehabil Psychol"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"CD013779","DOI":"10.1002\/14651858.CD013779","article-title":"Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review","volume":"2020","author":"Pollock","year":"2020","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1942675\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:18:17Z","timestamp":1788412697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1942675\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":63,"alternative-id":["10.3389\/fpubh.2026.1942675"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1942675","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1942675"}}