ParkProTrain: an individualized, tablet-based physiotherapy training programme aimed at improving quality of life and participation restrictions in PD patients – a study protocol for a quasi-randomized, longitudinal and sequential multi-method study

Abstract

Background Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. Patients suffer from a variety of motor and non-motor symptoms that severely affect their daily lives and quality of life. In many cases, a three-week inpatient Parkinson’s complex treatment (MKP) can improve the overall condition and quality of life of patients in a short time. In the outpatient sector, however, there is often a lack of human resources and structures necessary for the interdisciplinary treatment of the disease. To support PD patients in continuing the physical exercises they learned from the MKP on a regular basis, a tablet-based training programme will be developed in which exercises can be adjusted to the patient’s abilities. This programme is expected to increase quality of life and social participation, as well as delay the progression of the impairment. Methods a) Quasi-randomized, prospective longitudinal study (sequential study design). The intervention group receives a tablet-based training programme during and for 9 months after the MKP, and the control group receives treatment as usual. The evaluation is carried out by means of a written survey at three points in time (the beginning and end of the MKP and after 9 months). b) Qualitative analysis of interviews and focus groups in terms of feasibility and acceptance. c) Formative evaluation of the app and the administration panel. d) Evaluation of the implementation of the training programme by analysing the planned and performed physical activities, as well as evaluation of the phone calls between physiotherapists and patients. Discussion The tablet-based training programme can ensure continuous and long-term support for PD patients. They learn different self-management strategies during and after their MKP and are empowered to assume responsibility for carrying out regular physical activity on their own. Because common app stores have no scientifically evaluated apps for PD patients in the German language, the app can fill this gap and help PD patients receive high-quality care in the implementation of physically activating exercises regardless of their place of residence. In addition, the user-centred development of the app ensures that the app meets the specific needs of PD patients. Trial registration German Register of Clinical Trials, drks.de . Identifier: DRKS00014952. Registered on June 20th 2018. Date and version identifier April 25th 2019; version 1.

Structured Care and Self-Management Education for Persons with Parkinson’s Disease: Why the First Does Not Go without the Second—Systematic Review, Experiences and Implementation Concepts from Sweden and Germany

“…Sessions were scheduled once or twice a week, ranging from 45 to 150 min in duration. Two (11%) programs were restricted to the training of self-management behaviors and associated cognitive behavioral skills [ 25 ], 9 programs (50%) combined self-management support with other therapeutic measures, such as physiotherapy (7, 39%) [ 22 , 24 , 30 , 31 , 32 , 33 , 34 ], occupational therapy (4, 22%) [ 21 , 24 , 31 , 32 ], relaxation and body awareness techniques (7, 39%) [ 21 , 22 , 26 , 28 , 30 , 35 , 36 ] or speech therapy (4, 22%) [ 21 , 22 , 32 , 35 ]. All programs were carried out by healthcare professionals, several (9, 50%) by a multiprofessional team of up to 8 different healthcare professions [ 21 , 23 , 24 , 25 , 28 , 30 , 31 , 32 , 34 ].…”

“…With the exception of two programs [ 29 , 33 ], all others were delivered in an ambulatory outpatient setting, owing to their modular organization and duration over several weeks. One of the exceptions was a protocol for a future program (ParkProTrain) on physical activities: The program is to start during an intensive multimodal inpatient therapeutic program, but then to be continued independently at home for nine months with online sessions provided via an app [ 33 ]. One other study compared program delivery in small groups with home-based self-study [ 29 ].…”

“…For 5 programs (28%), a professional teaching manual was reported [ 25 , 26 , 28 , 29 , 32 ], for 4 (22%) teaching manuals and handouts to participants [ 24 , 30 , 32 , 34 ], and for 6 (33%) homework/home exercise programs in between single modules [ 22 , 30 , 31 , 32 , 35 , 37 ]. Only 2 programs (11%) explicitly report the integration of digital components [ 31 , 33 ]. As mentioned, one future program includes an app-based intervention at home [ 33 ].…”

“…Only 2 programs (11%) explicitly report the integration of digital components [ 31 , 33 ]. As mentioned, one future program includes an app-based intervention at home [ 33 ]. Another program reports the provision of program-supporting information on a patient-orientated webpage [ 31 ].…”

“…8 of the quantitative summative evaluation studies included additional formative elements [ 24 , 28 , 29 , 36 , 41 , 42 , 43 , 44 ], in addition to one quantitative study with a formative focus [ 42 ]. Examples of reported formative outcomes are: group experience, comprehensiveness, perceived usefulness, satisfaction, content relevance; 2/3 future protocols plan to report formative outcomes [ 25 , 33 ], 2/3 in a mixed methods design with a combination of qualitative and quantitative study methods.…”