Objective: To describe a remote, behavioral intervention designed to increase daily steps in Veterans with PD and report interim results from an ongoing clinical trial

Background: Physical activity (PA) levels are low and decline with disease duration in PD. Strategies to increase PA in real life settings are not well-defined or well-studied. Interventions employing insights from behavioral economics and wearable technologies can increase daily steps in many populations, but their utility in people with PD is unknown

Method: Single-arm clinical trial examining the feasibility and effect of gamification on daily steps in Veterans with PD. Gamification leverages insights from behavioral economics, including loss-framed points and levels, pre-commitment, and daily performance feedback to help motivate participants to meet step goals. Potential participants who reside within Veteran’s Integrated Service Area 4 (includes five states) are identified using administrative data, invited to participate via mail and complete a telephone screen for eligibility. This trial uses Way to Health, a web-based digital health platform that manages enrollment, survey administration, and automates step data collection (using hip-worn Fitbit monitors) and feedback messaging. Subjects undergo a 2 week baseline step collection, 6 week gamification period and 4 week followup. The trial will enroll 85 Veterans with a planned interim analysis on the first 34 completed participants. Baseline characteristics were summarized using descriptive statistics and change in daily steps from baseline was examined using linear mixed effects regression

Results: The interim analysis cohort had a mean (SD) age of 71 (6.1), disease duration of 6.5 (4.4) years and lived 170.6 (158.4) miles from the study site. Participants averaged 4949 (2713) steps at baseline. Overall, the mean change in daily steps from baseline was 943 steps (SE 446 steps, p < 0.01) with 68% of the sample achieving their step goal > 60% of intervention days

Conclusion: A remotely deployed gamification intervention allowed recruitment of people with PD living over 100 miles from the study site and increased PA. Updated results from the full cohort will be reported at the Congress. Scalable interventions leveraging wearables and remote monitoring platforms have wide reach and are a promising pathway for improving PA in Veterans with PD

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remotely-deployed-gamification-intervention-to-increase-physical-activity-in-parkinsons-disease/