Exploring the uptake and implementation of tele-monitored home-exercise programmes in adults with Parkinson’s disease: A mixed-methods pilot study

Background People with Parkinson’s disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants’ perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson’s disease. Methods Twenty adults with Parkinson’s disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach’s supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. Results Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. Conclusion Findings demonstrate that adults with Parkinson’s disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.

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Effect of Multimodal Exercise Training on Walking Economy in Individuals With Parkinson's Disease

Case Medical Research ◽

10.31525/ct1-nct03864393 ◽

2019 ◽

Author(s):

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Exercise Training ◽

Walking Economy

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Association between Objectively Measured Physical Activity and Gait Patterns in People with Parkinson’s Disease: Results from a 3-Month Monitoring

Parkinson s Disease ◽

10.1155/2018/7806574 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10

Author(s):

Micaela Porta ◽

Giuseppina Pilloni ◽

Roberta Pili ◽

Carlo Casula ◽

Mauro Murgia ◽

...

Keyword(s):

Physical Activity ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Analysis ◽

Time Slot ◽

Moderate Intensity ◽

Kinematic Parameters ◽

Gait Patterns ◽

Flexion Extension ◽

Vigorous Intensity

Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms of people with Parkinson’s disease (pwPD), little is known about the relationship between gait patterns and features of PA performed during daily life. Objective. To verify the existence of possible relationships between spatiotemporal and kinematic parameters of gait and amount/intensity of PA, both instrumentally assessed. Methods. Eighteen individuals affected by PD (10F and 8M, age 68.0 ± 10.8 years, 1.5 ≤ Hoehn and Yahr (H&Y) < 3) were required to wear a triaxial accelerometer 24 h/day for 3 consecutive months. They also underwent a 3D computerized gait analysis at the beginning and end of the PA assessment period. The number of daily steps and PA intensity were calculated on the whole day, and the period from 6:00 to 24:00 was grouped into 3 time slots, using 3 different cut-point sets previously validated in the case of both pwPD and healthy older adults. 3D gait analysis provided spatiotemporal and kinematic parameters of gait, including summary indexes of quality (Gait Profile Score (GPS) and Gait Variable Score (GVS)). Results. The analysis of hourly trends of PA revealed the existence of two peaks located in the morning (approximately at 10) and in the early evening (between 18 and 19). However, during the morning time slot (06:00–12:00), pwPD performed significantly higher amounts of steps (4313 vs. 3437 in the 12:00–18:00 time slot, p<0.001, and vs. 2889 in the 18:00–24:00 time slot, p=0.021) and of moderate-to-vigorous PA (43.2% vs. 36.3% in the 12:00–18:00 time slot, p=0.002, and vs. 31.4% in the 18:00–24:00 time slot, p=0.049). The correlation analysis shows that several PA intensity parameters are significantly associated with swing-phase duration (rho = −0.675 for sedentary intensity, rho = 0.717 for moderate-to-vigorous intensity, p<0.001), cadence (rho = 0.509 for sedentary intensity, rho = −0.575 for moderate-to-vigorous intensity, p<0.05), and overall gait pattern quality as expressed by GPS (rho = −0.498 to −0.606 for moderate intensity, p<0.05) and GVS of knee flexion-extension (rho = −0.536 for moderate intensity, p<0.05). Conclusions. Long-term monitoring of PA integrated by the quantitative assessment of spatiotemporal and kinematic parameters of gait may represent a useful tool in supporting a better-targeted prescription of PA and rehabilitative treatments in pwPD.

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The Effects of Group-Based versus Individual-Based Tai Chi Training on Nonmotor Symptoms in Patients with Mild to Moderate Parkinson’s Disease: A Randomized Controlled Pilot Trial

Parkinson s Disease ◽

10.1155/2017/8562867 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Jing Hui Yang ◽

Ya Qun Wang ◽

Sai Qing Ye ◽

You Gen Cheng ◽

Yu Chen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Tai Chi ◽

Compliance Rate ◽

Community Dwelling ◽

Home Exercise ◽

Hamilton Depression Scale ◽

Nonmotor Symptoms ◽

Randomized Controlled ◽

Exercise Compliance

Objective. To compare the effects of group-based and individual-based Tai Chi training on nonmotor symptoms in patients with mild to moderate Parkinson’s disease. Design. Randomized controlled pilot study. Methods. 36 community-dwelling patients with Parkinson’s disease (PD) were randomly assigned to either group-based training group (n=19) or individual-based group (n=17). Both groups received same content of Tai Chi training 3 times a week for 13 weeks. Participants were also asked to perform home exercises daily. The Non-Motor Symptoms Scale was used to assess global nonmotor symptoms change. Sleep quality, depression, and cognition were evaluated by Parkinson’s Disease Sleep Scale, Hamilton Depression Scale, and Beijing version-Montreal Cognitive Assessment, respectively. Home exercise compliance was recorded. Results. There was no significant difference between two groups at baseline. After 13 weeks, there were no statistical significance between two groups. However, the within-group effect was different. Participants in group-based and individual-based groups showed a significant improvement on global nonmotor symptoms (P<0.001, P=0.004) and sleep (P<0.001, P<0.001). But only group-based training patients presented a significant improvement in cognitive impairment compared with baseline (P=0.002, P-0.116). For depression, no group gained a significant improvement(P=0.123, P=0.170). Group-based participants had a higher home-exercise compliance rate (HeCR) than individual-based participants did (P=0.019), and HeCR showed a moderate correlation with MoCA-BJ and NMSS scores changes in this study. Conclusion. Group-based Tai Chi training is considered to be a more effective and a more labor-saving method in the clinical settings, and patients tend to have a higher compliance rate in their home exercise program. This study is registered with ChiCTR-IPR-17010388.

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Effects of Communal Exercise with ‘Parkinson Home Exercise’ Application on Functional Fitness and Brain Activation for Parkinson’s Disease Patients

Journal of Sport and Leisure Studies ◽

10.51979/kssls.2015.02.59.2.815 ◽

2015 ◽

Vol 59 (2) ◽

pp. 815-824

Author(s):

Myung-Ki Kim ◽

Hye-Young Cho ◽

Yun-Jin Park

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Brain Activation ◽

Home Exercise ◽

Functional Fitness

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Tai Chi–Based Exercise for Older Adults with Parkinson’s Disease: A Pilot-Program Evaluation

Journal of Aging and Physical Activity ◽

10.1123/japa.15.2.139 ◽

2007 ◽

Vol 15 (2) ◽

pp. 139-151 ◽

Cited By ~ 45

Author(s):

Fuzhong Li ◽

Peter Harmer ◽

K. John Fisher ◽

Junheng Xu ◽

Kathleen Fitzgerald ◽

...

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Performance ◽

Tai Chi ◽

Exercise Adherence ◽

Primary Objective ◽

Community Dwelling ◽

Preliminary Evaluation ◽

Exit Interviews

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson’s disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p< .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.

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