Objective: To examine the efficacy of the Engage-PD program in sustaining physical activity gains in people with Parkison disease.

Background: Parkinson disease (PD) is a chronic, progressive condition associated with decreased mobility, functional independence, quality of life, and increased mortality.[1] While physical activity (PA) can minimize PD symptoms and potentially modify disease progression, only a small percentage of people with PD (PwP) meet recommended PA levels.[2] We designed Engage-PD, a PA coaching program delivered via telehealth and grounded in self-determination theory, to promote PA uptake and facilitate exercise self-efficacy (ESE). ESE has been shown to play an important role in the uptake and adherence to PA in PwP.[3], [4] The Engage-PD program led to improvement in PA and ESE post-intervention.[5] However, we wanted to explore whether the gains attained post-intervention were maintained two months after the Engage PD program cessation.

Method: The Engage-PD program consisted of up to five telehealth coaching sessions over three months, delivered by trained rehabilitation specialists. Outcome measures were obtained post-intervention (1 week after the last coaching session) and at the 6-month follow-up from 22 PwP (14 males, age (yrs):65.27±8.48, BMI (kg/m²):23.79±3.02, Hoehn and Yahr I-III), which included the International Physical Activity Questionnaire (IPAQ), Brunel Lifestyle Physical Activity Questionnaire (Brunel), and ESE.[6], [7] We calculated the mean difference with a 95% confidence interval (CI) and Cohen’s d for IPAQ, Brunel planned, Brunel unplanned, and ESE.

Results: The mean differences of post-intervention to 6-month follow-up score with 95% CI and Cohen’s d were as follows: (a) IPAQ: 1396.75 (-303.11-3096.61), 0.36;(b) Brunel planned: -0.16 (-0.35-0.36), -0.36; (c) Brunel unplanned: 0.16 (-0.15-0.48), 0.23; (d) ESE: -7.18 (-13.87-(-0.50)), -0.48.

Conclusion: At a 6-month follow-up, PA levels were maintained, and exercise confidence levels showed slight improvement. The telehealth PA coaching program effectively maintained PA and exercise confidence levels even after the program ended. PA uptake intervention can be an important component of a consultative model of care for PwP.

References: [1]K. C. Stewart, H. H. Fernandez, M. S. Okun, C. E. Jacobson, and C. J. Hass, “Distribution of motor impairment influences quality of life in Parkinson’s disease,” Movement disorders: official journal of the Movement Disorder Society, vol. 23, no. 10, pp. 1466–1468, 2008.
[2]M. Benka Wallén, E. Franzén, H. Nero, and M. Hagströmer, “Levels and patterns of physical activity and sedentary behavior in elderly people with mild to moderate Parkinson disease,” Physical therapy, vol. 95, no. 8, pp. 1135–1141, 2015.
[3]L. A. King et al., “Effects of group, individual, and home exercise in persons with Parkinson disease: a randomized clinical trial,” Journal of Neurologic Physical Therapy, vol. 39, no. 4, pp. 204–212, 2015.
[4]S. D. Neupert, M. E. Lachman, and S. B. Whitbourne, “Exercise self-efficacy and control beliefs: Effects on exercise behavior after an exercise intervention for older adults,” Journal of aging and physical activity, vol. 17, no. 1, pp. 1–16, 2009.
[5]H.-J. S. Shih et al., “Physical activity coaching via telehealth for people with Parkinson disease: a cohort study,” Journal of Neurologic Physical Therapy, vol. 46, no. 4, pp. 240–250, 2022.
[6]S. Ånfors, A.-S. Kammerlind, and M. H. Nilsson, “Test-retest reliability of physical activity questionnaires in Parkinson’s disease,” BMC neurology, vol. 21, pp. 1–13, 2021.
[7]C. Karageorghis, M. Vencato, N. Chatzisarantis, and A. Carron, “Development and initial validation of the Brunel lifestyle physical activity questionnaire,” British Journal of Sports Medicine, vol. 39, no. 5, pp. e23–e23, 2005.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-telehealth-physical-activity-coaching-program-can-maintain-physical-activity-and-exercise-confidence-in-people-with-parkison-disease-a-cohort-study/