Objective: The study evaluates the effectiveness of Combat PD, a mobile app designed to remotely deliver and monitor gamified aerobic exercise in promoting adherence and relieving motor symptoms in people with mild Parkinson’s disease (PD).

Background: While moderate-to-high intensity aerobic exercise may delay early PD progression, maintaining adherence is challenging. Combat PD is a digital solution to deliver therapeutic exercises to patients with PD.

Method: In this double-blind randomized controlled trial at a Singapore tertiary outpatient centre, sedentary individuals with PD were randomly assigned to either gamified aerobic exercises using Combat PD with brisk walking or app-based stretching exercise with brisk walking (Control). Both groups exercised at home for 30 minutes, thrice weekly for 12 weeks, with remote heart rate monitoring. Primary outcome was exercise adherence, with secondary outcomes of including off-state MDS-UPDRS motor score, Timed Up and Go (TUG), cognitive TUG, 6-minute walk test, Hospital Anxiety and Depression Scale (HADS), Fatigue Severity Scale (FSS), Scales for Outcomes in Parkinson’s disease (SCOPA-sleep), and the Parkinson Disease Questionnaire (PDQ)-8.

Results: Of 23 patients (12 intervention, 11 control) enrolled between January 2023 and December 2024, 20 completed the study. The mean frequency and duration of exercise were 3.6±1.6 and 4.6±2.3 sessions/week for intervention and control group respectively, with mean session duration of 38.0±11.8 and 31.6±8.9 minutes respectively. While participants in intervention group spent average 32% (range 0-61) of the exercise time in the prescribed heart rate zones (i.e. 40-60% heart rate reserve), 60% reported moderate-intensity exercise levels (Borg exertional ratings >12).  Both groups showed significant improvements in TUG (intervention: -1.7±1.6, p=0.009; control: -1.4 ±1.6, p=0.024) and cTUG (intervention: -3.2 ±2.2, p=0.002; Control: -1.9±1.3, p=0.001).

Conclusion: Mobile app-based exercise programs can effectively deliver and monitor home-based exercises for individuals with mild PD, achieving acceptable adherence rate of 12 weeks. While both interventions improve functional mobility, larger trials are needed to determine if gamified aerobic exercise offer additional benefits over conventional exercises.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-randomised-controlled-feasibility-study-of-a-technology-assisted-home-based-aerobic-exercise-program-for-individuals-with-parkinsons-disease/