Objective: To evaluate the feasibility of adapting our Agility Boot Camp (ABC) for balance telerehabilitation (Tele-ABC) in people with mild-to-moderate Parkinson’s disease (PD).

Background: Balance impairments that lead to falls are one of the main symptoms of PD. Telerehabilitation by videoconferencing is becoming more common for people with PD; however, this approach for PD lacks strong evidence-based trials (1). Clinical Practice Guideline recommends implementing aspects of task specificity that target specific impairments in PD such as anticipatory postural adjustments, sensory integration, and challenging gait to improve balance (2). It is unknown if these recommendations can be safely implemented into balance telerehabilitation.

Method: The Telerehabilitation for PD (TelePD) trial is a prospective, single-center, parallel-group, single-blind, randomized controlled trial (3). Eighty people with PD will be randomized into either Tele-ABC by videoconferencing (n=40) or unsupervised-ABC (n=40). Both groups will perform 12 sessions of exercise (60 minutes). Primary (MiniBESTest) and secondary outcomes (e.g., objective measures of balance and gait) will be assessed pre- and post-interventions.

Results: To date, 19 people with mild-to-moderate PD have completed the study (age 69.7[6.4], H&Y 2.4[0.5], disease duration 8.8[6.1] yrs, MoCA 26.4[1.8], MiniBESTest 18.9[3.7]). Of these, 32% are female, 21% are freezers, 42% reported falls in the last year, and 21% live alone. Currently, we have had 3 falls related to the study (1 during virtual assessment, 1 during home assessment, 1 during Tele-ABC exercises) and 7 falls unrelated and outside of the study activities. The 3 people with falls related to study activity were all H&Y 3, had normal cognition (MoCA > 25) but had lower scores on MiniBESTest compared to those without falls during the study (13.3[2.1] vs 20[2.9]; p=0.04). The compliance is high for both groups (Tele-ABC (n=10; 99.1%) and unsupervised-ABC (n=9; 99.2%).

Conclusion: Our preliminary data show suggest Tele-ABC is feasible and safe for most people with mild-to-moderate PD.

References: 1) van den Bergh R, Bloem BR, Meinders MJ, Evers LJW. The state of telemedicine for persons with Parkinson’s disease. Curr Opin Neurol. 2021;34(4):589–97.
2) J.A. Osborne, R. Botkin, C. Colon-Semenza, T.R. DeAngelis, O.G. Gallardo, H. Kosakowski, et al., Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association, Physical therapy 102(4) (2022).
3) C. Silva-Batista, J.L. Wilhelm, K.T. Scanlan, M. Stojak, P. Carlson-Kuhta, S. Chen, et al., Balance telerehabilitation and wearable technology for people with Parkinson’s disease (TelePD trial), BMC neurology 23(1) (2023) 368.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-the-feasibility-of-telerehabilitation-for-balance-deficits-in-people-with-pd-the-telepd-trial/