Objective: To examine feasibility of a remote physical activity monitoring program and predictors of activity among rural Veterans with PD

Background: Patients in rural areas, particularly those with chronic neurologic diseases like PD, experience limited access to high-technology care, report worse physical health and quality of life and are underrepresented in research. Interventions increasing physical activity in PD may improve outcomes but little is known about daily activity levels and predictors of activity in rural Veterans with PD. A critical step in offering novel physical activity programs to rural Veterans and non-Veterans is to examine the feasibility of these programs and capture baseline activity data.

Method: Rural-dwelling Veterans with PD were identified using administrative data, mailed a recruitment letter, contacted the study team via phone and provided oral consent. Potential predictors of activity (self-efficacy, apathy, social support) were quantified with surveys completed online via Way to Health (WTH), a web-based remote monitoring platform. Participants were mailed a wearable device (Fitbit Inspire HR) to wear for 30 days, and activity data were automatically acquired when participants synced their device to the WTH platform. Feasibility was measured by response rate, completion rate, and adherence. Daily steps were evaluated descriptively. We examined associations of demographics, disease duration, and survey data with activity using a linear mixed effects regression model.

Results: The cohort was comprised of 20 rural-dwelling Veterans with PD. Recruitment response rate was 11%. Twenty-eight individuals with PD were consented and 71% completed the study. Device adherence was high, with step data acquired for 97% of subject-days. Average step counts were 3476 ± 3269/day. Results from the adjusted analysis indicated that age was the only significant predictor of daily steps (-265 steps, 95% CI [-401, -123], P < 0.001).

Conclusion: A remote physical activity monitoring program for rural Veterans with PD was feasible. Age was associated with lower step counts. Remote monitoring technology can extend care to rural-dwelling individuals that may help improve self-management of chronic health conditions. These programs are highly scalable for clinical research and we are expanding these studies with interventions to increase activity levels in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/remote-physical-activity-monitoring-programs-for-veterans-with-parkinsons-disease/