Date Presented 04/05/2025
This study evaluates the feasibility and effects of Pre-Active PD Telehealth coaching for people with early Parkinson’s disease (PwP). High adherence and goal attainment suggest that OT telehealth enhances self-management of physical activity (PA) routines in PwP.
Primary Author and Speaker: Katrina M. Long
Contributing Authors: Alissa C. Pacheco, Dipti Wani, Jehan C. Alomar, Danielle C. Kipnis, Chelsea C. Macpherson, Lilliana Romero, Fatima Awad, Lori Quinn
PURPOSE: To assess the feasibility, acceptability, and effects of Pre-Active PD intervention delivered via telehealth for increased physical activity (PA) engagement in people with early Parkinson disease (PwP). Growing evidence supports PA and exercise as central to managing symptoms in PwP. While disease-specific exercise programs are well developed, there is a need for occupational therapist (OT) delivered coaching to support PwP to improve PA routines.
DESIGN: A single-blind randomized controlled trial of two groups: occupational therapy coaching (OT) or education-only (E). Each group matched for contact time. Assessments performed at baseline, 4 and 6 months.
METHODS: Offered in Spanish/English with aim to increase diversity. OT group received support in PA self-management in 6 individual telehealth sessions over 4 months. Fitbits were provided to support habit formation and provide PA and HR feedback. Primary outcome measures assessed feasibility, acceptability (participant adherence, retention, Fitbit Wear-time; Perceived Autonomy Support), and implementation fidelity. Secondary outcomes included PA levels measured by wearable activity monitor, PA questionnaire, and Life Space Questionnaire. Self-perception of performance and ability was assessed using Modified Canadian Occupational Performance Measure (mCOPM) and Perceived Functional Ability Questionnaire. Exercise self-efficacy and motivation were also assessed.
RESULTS: 129 individuals were screened, 50 enrolled and 43 were randomized, with 22 in OT group and 21 in E group. Participant characteristics: mean age 64.44(7.53); 25 men, 18 women, Race: 1 Black, 3 Other, 5 Asian, 34 White. OT group: high retention (91%), adherence (95%), perceived autonomy support 6.4(0.46) (out of 7), and clinically important changes in self-perception of performance and satisfaction in 79% of participant goals (n = 48 goals).
CONCLUSION: Findings suggest Pre-Active PD may be feasible to implement with early-stage PwP.
References
Quinn, L., Macpherson, C., Long, K., & Shah, H. (2020). Promoting Physical Activity via Telehealth in People With Parkinson Disease: The Path Forward After the COVID-19 Pandemic? Physical Therapy. https://doi.org/10.1093/ptj/pzaa128
Shih, H. S., Macpherson, C. E., King, M., Delaney, E., Gu, Y., Long, K., Reid, J., Fineman, J., Yu, G., Rieger, J., Satchidanand, A., Shah, H., Alcalay, R. N., & Quinn, L. (2022). Physical Activity Coaching via Telehealth for People With Parkinson Disease: A Cohort Study. Journal of Neurologic Physical Therapy: JNPT, 46(4), 240–250.
Long, K. (2020). Pre-active PD: A therapist delivered physical activity behavior change program for people with early - stage Parkinson’s Disease. Available from ProQuest Dissertations & Theses Global. (2359437963). https://doi.org/10.7916/d8-d59j-tb74
Langeskov-Christensen, M., Franzén, E., Grøndahl Hvid, L., & Dalgas, U. (2024). Exercise as medicine in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, jnnp-2023-332974. https://doi.org/10.1136/jnnp-2023-332974
