Date Presented 03/23/24
PreActive-PD, a randomized controlled trial, will evaluate the effects of telehealth coaching to support physical activity goal setting and participation in people with early-stage Parkinson’s disease. Design and baseline characteristics will be discussed.
Primary Author and Speaker: Katrina M. Long
Additional Authors and Speakers: Alissa C. Pacheco
Contributing Authors: Lori Quinn
PURPOSE: Parkinson’s Disease (PD) is a progressive neurodegenerative disorder. Engagement in exercise and physical activity (PA) produces positive effects in people with PD (PwP), including improvements in motor and cognitive functions, and decreased symptom progression. Recently diagnosed PwP are 1/3 less active than healthy adults and PA levels continue to decline throughout the course of the disease The purpose is to evaluate the feasibility of an OT telehealth coaching intervention to improve self-management of PA routines, and its effects on PA & exercise levels, self-efficacy, motivation, and self-perception of performance.
DESIGN: This single-blind, randomized controlled feasibility design will randomize 50 adults with early-stage PD (H&Y 1-2) into either the OT intervention or education group, with special focus on enrolling underserved and diverse participants. Each participant will be assessed at basline and again at month four and six. The intervention is available in English and Spanish, and participants will receive six 1-1 telehealth sessions with an OT over the course of 4 months to provide direct support regarding routines, habits and individualized goals, with check-ins on altermnate weeks. Fitbit devices will be provided to track progress and facilitate coaching.
RESULTS: 96 individuals have been reffered (15 Spanish speakers, 81 English): 23 did not meet inclusion criteria, 24 declined to participate, 9 did not respond, and 40 were screened. 24 people have been randomized.
CONCLUSION: The PreActive-PD intervention is expected to produce new findings about telehealth coaching and inform tailored OT interventions to support physical activity habits and routines in adults with early-stage PD. Special consideration must given to technology literacy and access especially to underserved populations. MOCA scores, social and environmental supports should also be considered when determining the best modality for PA coaching interventions.
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
Rafferty, M. R., Nettnin, E., Goldman, J. G., & MacDonald, J. (2021). Frameworks for Parkinson’s Disease Rehabilitation Addressing When, What, and How. Current Neurology and Neuroscience Reports, 21(3). https://doi.org/10.1007/S11910-021-01096-0
Sadural, A., MacDonald, J., Johnson, J., Gohil, K., & Rafferty, M. (2022). Occupational Therapy for People with Early Parkinson’s Disease: A Retrospective Program Evaluation. Parkinson’s Disease, 2022. https://doi.org/10.1155/2022/1931468
Quinn, L., Busse, M., Khalil, H., Richardson, S., Rosser, A., & Morris, H. (2010). Client and therapist views on exercise programmes for early-mid stage Parkinson’s disease and Huntington’s disease. Disability and Rehabilitation, 32(11), 917–928. https://doi.org/10.3109/09638280903362712
