Physical Activity Coaching via Telehealth for People With Parkinson Disease: A Cohort Study

Abstract

Background and Purpose: Physical activity (PA) has many known benefits for people with Parkinson disease (PD); however, many people do not meet recommended levels of frequency or intensity. We designed Engage-PD, a PA coaching program delivered via telehealth and grounded in self-determination theory to promote PA uptake and facilitate exercise self-efficacy in people with Parkinson disease. This study aimed to determine the feasibility and preliminary efficacy of Engage-PD, and to explore whether baseline characteristics were associated with outcomes. Methods: A single cohort of people with PD (n = 62, Hoehn and Yahr I-III) participated in the 3-month Engage-PD program, which consisted of up to 5 telehealth coaching sessions delivered by physical therapists. Feasibility was evaluated based on recruitment and retention rates, along with participants' feedback. Planned and unplanned PA, exercise self-efficacy (ESE), and individualized goals were assessed pre- and post-intervention. Relationships between baseline characteristics and changes in planned PA and ESE were also evaluated. Results: Recruitment (62%) and retention (85%) rates were high, and the intervention was well accepted and perceived by the participants. From pre- to postintervention, participants increased planned PA (d = 0.33), ESE (d = 1.20), and individualized goal performance (d = 1.63) and satisfaction (d = 1.70). Participants with lower baseline planned PA experienced greater improvements in planned PA, and those with lower baseline ESE experienced greater improvements in ESE. Discussion and Conclusions: A telehealth PA coaching program for people with PD was feasible and potentially efficacious. Physical therapist-led coaching may be an important component of a consultative model of care starting early in the disease process. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A393).

Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease

“…Obtaining survey data prior to the virtual visit allows therapists to be more efficient with interview time, by developing focused, personalized discussion points. Although many physical therapy interventions for PwP are amenable to telehealth, development of an individualized multimodal intervention plan requires a comprehensive examination battery to facilitate clinical decision making, design the plan of care, and evaluate patient progress (Flynn et al, 2023;Osborne et al, 2022;Quinn et al, 2020;Shih et al, 2022;van der Kolk et al, 2019). One of the primary concerns in telehealth is safety of administering tests and measures when a therapist is not in person to provide guarding and environmental cueing (Bennell et al, 2021;Bianchini et al, 2022;Colón-Semenza et al, 2023;Cubo et al, 2021;Thwaites et al, 2023).…”

“…Several studies have supported the feasibility and efficacy of telehealth-delivered interventions for PwP ( Shih et al, 2022 ; Vellata et al, 2021 ). While researchers have used a range of outcome assessments in these studies, there has not been a structured approach to conducting physical therapy assessments via telehealth for PwP.…”

Telehealth-based exercise in amyotrophic lateral sclerosis

“…Based upon data from a review of 10 randomized control trials, Ortega-Hombradros ( 19 ) concluded that combined resistance and aerobic exercise programs should be completed at a moderate intensity, 2x/week to maximize benefits and reduce risk of worsening fatigue. Effective telehealth multimodal telerehabilitation exercise programs have been described in the Parkinson’s ( 20 ) and Duchenne muscular dystrophy ( 21 ) populations.…”