Objective: To investigate the feasibility of a smartphone app (STEPWISE app) to increase the physical activity level (i.e. number of steps) in people with Parkinson’s disease (PD) over the course of one year. We will also evaluate the effect of an increase in physical activity on physical fitness, motor- and non-motor functioning.

Background: The positive effects of exercise for people with PD are nowadays generally accepted but implementing exercise in daily life and long term adherence remain challenging. Moreover, the exact volume and intensity of exercise that are needed to reach clinically significant effects remains unclear. To structurally increase physical activity of people with PD, we need interventions that are motivating and fun, accessible, and scalable.

Method: We will conduct a double-blind randomized controlled trial. A total of 452 Dutch people with PD who are able to walk independently (Hoehn and Yahr 1-3) and do not take more than 7.000 steps per day will be randomized into one of four groups. All groups will be encouraged to increase their physical activity level, measured in step counts on the participants’ own smartphone to a different degree: a small (active controls), intermediate, large or very large increase in step count compared to their own baseline step count level. The primary endpoint will be change in number of steps from baseline to follow-up (12 months). Secondary outcomes will be various measures of physical fitness, motor- and non-motor functioning.

Results: The first participant was included in July 2021 and we anticipate to include the last participant in July 2023.

Conclusion: This study will provide us with new insights into the potential of a decentralized smartphone-based intervention and also into the effect of different doses of physical activity. We envision that in future, motivational apps could support people with chronic diseases such as PD worldwide to structurally become more physically active.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-stepwise-parkinson-study-a-smartphone-based-exercise-solution-for-patients-with-parkinsons-disease/