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Accepted for/Published in: JMIR Formative Research

Date Submitted: Nov 15, 2023
Date Accepted: May 13, 2024

The final, peer-reviewed published version of this preprint can be found here:

The Use of Telerehabilitation to Improve Movement-Related Outcomes and Quality of Life for Individuals With Parkinson Disease: Pilot Randomized Controlled Trial

Johnson JK, Longhurst JK, Gevertzman M, Jefferson C, Linder SM, Bethoux F, Stilphen M

The Use of Telerehabilitation to Improve Movement-Related Outcomes and Quality of Life for Individuals With Parkinson Disease: Pilot Randomized Controlled Trial

JMIR Form Res 2024;8:e54599

DOI: 10.2196/54599

PMID: 39083792

PMCID: 11325111

The use of telerehabilitation to improve movement-related outcomes and quality of life for individuals with Parkinson’s disease: A pilot randomized controlled trial

  • Joshua Kurt Johnson; 
  • Jason K. Longhurst; 
  • Michael Gevertzman; 
  • Corey Jefferson; 
  • Susan Marie Linder; 
  • Francois Bethoux; 
  • Mary Stilphen

ABSTRACT

Background:

Individuals with Parkinson’s disease (PD) can improve overall mobility and participation in daily activities as they engage in frequent exercise. Despite the need for individually tailored exercises, persons with PD often face barriers to accessing physical rehabilitation professionals who can provide them. Telerehabilitation (TR) may facilitate access to necessary and individually tailored rehabilitation for individuals with Parkinson’s disease (PD).

Objective:

The purpose of this study was to assess the feasibility of TR for individuals with PD and explore clinical outcomes compared to in-person care.

Methods:

This was a pilot randomized controlled trial conducted at two outpatient neurorehabilitation clinics with three study groups: clinic+TR, TR-only, and usual care. TR was administered using a web-based application with a mobile application option. One-hour interventions were performed weekly for four weeks, in-person for the clinic+TR and UC groups and virtually for the TR-only group. Home exercises were provided on paper for the UC group and via the virtual platform for the clinic+TR and TR-only groups. Feasibility was assessed by recruitment and retention success, and patient/therapist satisfaction as rated in surveys. Clinical outcomes were explored using performance and patient-reported measures in between- and within-group analyses.

Results:

Of 389 patients screened, 68 (17.5%) met eligibility criteria and 20 (29.4% of those eligible) were enrolled (Clinic+TR, N=6; TR-only, N=6; usual care, N=8). One patient (TR-only) was withdrawn due to a non-study related injurious fall. Regardless of group allocation, both patients and therapists generally rated the mode of care delivery as “good” or “very good” across all constructs assessed, including overall satisfaction and safety. In the analysis of all groups, there were no differences in clinical outcomes at the discharge visit. Within-group differences (from baseline to discharge) were also generally not significant except in the UC group (faster 5-time sit-to-stand time and higher mini BESTest balance score) and Clinic+TR group (higher mini BESTest balance score).

Conclusions:

High satisfaction amongst patients and clinicians regardless of group, combined with non-significant between-group differences in clinical outcomes, suggest that TR is feasible for PwPD in early-moderate stages. Future trials with a larger sample are necessary to test clinical effectiveness. As larger trials enroll patients with diverse characteristics (e.g. in terms of age, disease progression, caregiver support, technology access and capacity, etc.), they could begin to identify opportunities for matching patients to the optimal utilization of TR as part of the therapy episode.


 Citation

Please cite as:

Johnson JK, Longhurst JK, Gevertzman M, Jefferson C, Linder SM, Bethoux F, Stilphen M

The Use of Telerehabilitation to Improve Movement-Related Outcomes and Quality of Life for Individuals With Parkinson Disease: Pilot Randomized Controlled Trial

JMIR Form Res 2024;8:e54599

DOI: 10.2196/54599

PMID: 39083792

PMCID: 11325111

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