JMIR Publications

ABSTRACT

Background:

The rising prevalence of Parkinson’s disease and the growing demand on the healthcare system underscore the need for accessible and innovative care solutions such as Reality DTx® - an augmented-reality neurorehabilitation program with remotely-prescribed gait-and-balance exercises at home for people with Parkinson’s disease.

Objective:

At a pre-implementation stage, this qualitative study aimed to explore the acceptability of Reality DTx®.

Methods:

We conducted semi-structured interviews, guided by the Theoretical Framework of Acceptability, with 22 people with Parkinson’s disease who used Reality DTx® at home for six weeks as part of a clinical feasibility trial. Data was thematically analyzed and thoroughly discussed in triangulation.

Results:

Participants reported variable perceptions of effectiveness and variable experiences of effort to complete the Reality DTx® program. They viewed Reality DTx® as a valuable complement to supervised physical therapy and emphasized the indispensable role of the physical therapist for external control of long-term exercise adherence and for meaningful feedback on motor performance, as well as the desire for social connection. Flexibility in time and location was mentioned as a very important program characteristic, supporting long-term exercise adherence. Suggestions for improvement included enhanced visibility of progression in scores, increased variation in games, and integration of competitive elements.

Conclusions:

Remotely-prescribed augmented-reality exercises at home, complementary to supervised physical therapy, are acceptable to people with Parkinson’s disease. The findings inform future Reality DTx® development and implementation from the perspective of people with Parkinson’s, which should be weighted with the perspectives of other stakeholders like clinicians and other key decision makers.