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Summary

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There is strong evidence that increased exercise is associated with slower declines in mobility and quality of life among people with Parkinson¡¯s. However, there are also several barriers to starting and maintaining exercise. Recent studies have shown that clinicians can use digital health technology and behavior change interventions to help people with Parkinson¡¯s to increase their exercise. This project aims to facilitate digital health technology use into physical therapy (PT) practice for people with early Parkinson¡¯s disease.

As part of the study we will develop, disseminate, and test strategies that can improve the use of digital health technology and behavior change interventions in PT and real-world practice. Below you will find several of these resources developed:

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Resources for People with Parkinson's

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Resource for Physical Therapists

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Preliminary Results

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BARRIERS & FACILITATORS

In the initial phase of study, we conducted interviews with people with Parkinson¡¯s disease, physical therapists, and technology stakeholders. The purpose of this phase was to describe barriers and facilitators to using digital health technology in PT.

Results of the interviews suggest that clinicians should simplify digital health technology in PT to increase use by people with PD. Recommendations for PT include (1) identifying user-friendly features in apps, (2) gathering resources for both clinicians and patients, (3) using individualized approaches, and (4) engaging family, social, and clinical support.

The poster below depicts these results and provides some specific quotes from participants:

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IMPLEMENTATION FIDELITY

We wanted to explore how physical therapists (PTs) can use digital health technology (DHT) and behavior change approaches to help PwP meet exercise goals. We audited the initial session documentation of 30 historic control and 30 participants in the study. All of these sessions occurred in three outpatient rehabilitation clinics with individuals involved in the program for people with early stage Parkinson¡¯s disease.

The PTs had 100% adherence to documenting self-reported baseline exercise for PwP. Implementation aimed to promote the use of DHT and a behavior change approach for exercise adherence in a group of PwP.  Implementation strategies included interactive training, facilitation, documentation guidance and clinical resources/education for use with patients.

Trained PTs were more likely to document DHT as a tool for exercise monitoring after training, especially smart phones, fitness apps and wearables. These PTs were also more likely to document detailed information regarding various types of exercise such as aerobic & strength training. See link to the poster for more information below.

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Accelerating Physical Therapy Exercise Monitoring through Digital Health Technology for People with Parkinson¡¯s 

The purpose of this phase of the study was to explore if physical therapists (PT) can promote digital health technology (DHT) use in people with Parkinson¡¯s (PwP) who were referred to an early intervention, low-dose consultative model of physical therapy. We hypothesized that increased DHT use would be associated with improved self-report of exercise and physical function.   

We enrolled 33 PwP over a 15-month period. Patients completed surveys and functional outcome measures at baseline and 6-months. PwP received an initial consultative PT assessment, follow-up DHT support as needed by a research facilitator, and a follow-up research evaluation at 6 months.  PwP and PTs completed exit interviews about their experiences.  

Recorded frequency and intensity of aerobic and strengthening exercises increased in PT documentation. The number of PwP reporting using DHT ¡Ý5 days/week increased from 11 to 18 and function remained stable, but there was no significant change mean minutes of exercise per week. PwP exit interviews suggest higher adoption of DHT for those who were initially more comfortable or eager to learn technology. PT exit interviews suggest that they value using DHT and scaled DHT recommendations to other patient populations.  

These findings suggest that PT education and engagement can positively impact patient-reported use of DHT and facilitate increased exercise in PwP. With this intervention delivery, patients remained functionally stable through 6 months.  

Incorporating DHT into physical therapy practice may be valuable to improve exercise adherence for PwP. 

For more information, click on the abstract document below that was accepted for a poster presentation at the 2024 APTA CSM.

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Additional KTEAM Projects

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Coming soon!