Objective: This study aims to evaluate the nationwide scale-up of standardized Parkinson’s rehabilitation programs across Singapore’s community care sector using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, with explicit focus on health equity and economic value.

Background: Exercise and rehabilitation are strongly recommended for individuals with Parkinson’s disease to improve mobility, function, and quality of life. However, access to structured, evidence-based programs remains inconsistent in community settings. In Singapore’s rapidly ageing population, scalable models are needed to ensure equitable access to effective rehabilitation.  Prior to national scale-up, a “sandbox” pilot was conducted in selected site to test program feasibility, delivery models, and implementation strategies.

Method: This multi-site, hybrid type III implementation study will expand a standardized physiotherapy led rehabilitation program across community providers in partnership with the community service providers and regional health systems. The program emphasizes on progressive aerobic and strengthening exercises, task -specific training, and self-management support. Lessons from the pilot informed implementation strategies including stakeholder co-design, workforce training and competency certification, implementation toolkits, and audit-and-feedback cycles. Evaluation will follow the RE-AIM framework: Reach will access population penetration and representative from across disease stage; Effectiveness will examine functional mobility, fall rates, participation, and health-related quality of life; Adoption will measure organizational uptake; Implementation will assess fidelity, adaptations, and delivery costs); and Maintenance will evaluate sustainability over 5 years. Cost and cost-effectiveness analysis will estimate fall related healthcare utilization, and cost per quality-adjusted life year gained.

Results: The initial sandbox phase demonstrated feasibility and acceptability with high program completion rates and improvement in mobility and functional performance tests among participants.

Conclusion: This study will generate evidence on how evidence-based Parkinson’s rehabilitation can be equitably scaled within Singapore’s community health system, informing sustainable service models and national rehabilitation policy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/scaling-evidence-based-community-rehabilitation-for-parkinsons-disease-for-singapore-a-nationwide-re-aim-implementation-study-protocol/