Objective: To investigate the feasibility of a remotely-monitored home-based exercise program for people with Parkinson’s disease (PD) delivered following a centre-based exercise and exercise self-management program.

Background: Exercise is an integral aspect of the physiotherapy management of PD. Home-based exercise is convenient, affordable and accessible. Increasingly home-based exercise programs are incorporating exercise self-management and remote monitoring components to promote adherence.

Method: A randomised feasibility trial. Forty community dwelling people with PD completed a 10-week exercise intervention divided into two 5-week blocks. In block 1 all participants completed predominantly centre-based exercise plus a self-management program at a University clinic.  Participants were then randomised to continue the centre-based exercise (n=20) or to a remotely-monitored home-based exercise program (n=20) for block 2. The exercise targeted balance and gait and was prescribed by an experienced physiotherapist. The primary outcomes were the feasibility and acceptability of the intervention. Secondary outcomes were balance (MiniBESTest), gait speed and freezing of gait (New Freezing of Gait Questionnaire).

Results: The intervention was feasible and acceptable. Adherence was high in block 1 (93%), and in block 2 (centre-based group = 93%, home-based group = 84%). The average time taken to develop the exercise programs was the same for both groups (15 minutes per program per participant).  In block 2 the physiotherapist spent 6.4 hours remotely-monitoring the home-based group and 32.5 hours delivering the centre-based exercise classes in total. Participants reported that exercise was helpful, they could follow the home exercise program and they would recommend exercising at home or in a group. However, exercising at home was less satisfying and there was a mixed response to the acceptability of the self-management program. There was no difference between groups in any of the secondary outcome measures.

Conclusion: Remotely-monitored home-based exercise for people with PD is feasible and acceptable from a participant and service delivery perspective. Further research is required to determine if improving the self-management program would increase the satisfaction with home-based exercise.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remotely-monitored-home-based-physiotherapy-is-feasible-for-both-people-with-parkinsons-disease-and-physiotherapists/