Objective: To evaluate the effects of an eHealth-supported, motor-cognitive, home-based exercise intervention on self-reported walking difficulties and walking performance in individuals with Parkinson’s disease (PD).

Background: Exercise supports slower PD progression. Dual tasking, the ability to perform two tasks at once, is often impaired in PD but can improve through motor-cognitive training (MCT). Most evidence comes from clinic‑based MCT, while emerging eHealth‑supported home‑based MCT studies show safety and feasibility. However, it remains unclear whether digitally delivered home-based MCT improves walking capacity or perceived walking difficulties in people with PD.

Method: The data collection was part of the randomized controlled STEPS trial (Support for home Training using Ehealth in Parkinson’s diseaSe), conducted in Stockholm, Sweden, between 2022 and 2024. Participants were randomly assigned to the intervention or control group, both completing a ten‑week home‑based exercise program performed three times weekly. The intervention included digitally delivered motor‑cognitive exercises and encouragement to increase physical activity. Perceived walking difficulties were assessed with the Generic Walk‑12, and walking performance with the two‑minute walk test under single‑task (ST) and dual‑task (DT) conditions. Baseline and post‑intervention data were analyzed using linear mixed models with a group × time interaction.

Results: A total of 138 participants completed baseline measurements (mean age: 69.5 years; mean Hoehn & Yahr: 2.3), and 113 completed the full trial. Perceived walking difficulty showed a significant group interaction effect (-1.89, p=0.044), favoring the intervention group. Scores in the intervention group decreased (-1.19, p=0.077), whereas scores in the control group increased (0.69, p=0.280).  In the two-minute walk test, the intervention group significantly improved their walking distance under both single and dual-task conditions (ST: 8.51 meters, p< 0.001; DT: 7.32 meters, p<0.001) while the control group showed no significant changes (ST: 2.67 meters, p= 0.101; DT: 1.29 meters, p=0.520). Group interactions were significant for both conditions (ST: p=0.013; DT: p=0.036).

Conclusion: Following a 10-week home-based MCT program, people with PD improved both their perceived walking ability and walking performance under single and dual-task conditions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-a-motor-cognitive-ehealth-supported-home-exercise-program-on-walking-difficulties-and-performance-in-parkinsons-disease/