Objective: Use a mixed-methods approach to evaluate wear-time and physical activity (PA) levels, and explore individual perspectives and feature preferences of people with Parkinson Disease (PwP) using a consumer-wearable device enrolled in a PA behavior change intervention.

Background: Evidence supports 120-150 minutes per week (min/wk) of moderate-vigorous PA (MVPA) for PwP [1], [2], [3], [4]. Consumer-wearable PA devices have validated PA outcomes, high internal responsiveness to change, and are used in PA behavior change interventions for PwP [5], [6], [7]. Preliminary results indicate PwP find these devices useful to monitor PA, [8] however, there is limited research examining the devices’ role in monitoring PA, PA goals, and user perspectives.

Method: PreActivePD is a randomized controlled trial evaluating a 16-week PA behavior change intervention for PwP compared to exercise education. The intervention group (n=21) received 6 sessions via telehealth by an occupational therapist focused on increasing MVPA through exercise education, collaborative goal setting, and supportive self-management strategies. Participants wore a wearable device for PA monitoring during the intervention. We analyzed quantitative data to determine wear-time, MVPA, and step count. Qualitative data were analyzed for themes regarding perspectives on device use from semi-structured interviews completed post-intervention.

Results: Preliminary data (n=7) shows that percent wear-time (mean± SD) for PwP over the intervention was 92.9(±3). Step count increased by a mean of 128 steps/wk and 363 steps/month. Daily steps mean(SD) by end of the study was 7121(5334), compared to 6148(4861) at the beginning (p=.161). Mean(SD) MVPA (min/wk) at the end of the study was 95(51), compared to 82(52) at the beginning (p=.189). Preliminary themes from interviews revealed the importance of real time data tracking, user accountability, device feedback, and the combination of coaching and a wearable device.

Conclusion: Preliminary analysis suggests that PwP have high wear-time and their total step count and MVPA increased during the intervention; however, clinical meaningfulness is not yet determined. PwP reported wearable devices were useful for accountability, feedback, and real time data, which support disease self-management and tracking individual PA over time. The importance of using a wearable device alongside a coaching program is also emphasized.

References: [1] J. L. Alberts and A. B. Rosenfeldt, “The Universal Prescription for Parkinson’s Disease: Exercise,” J Parkinsons Dis, vol. 10, no. Suppl 1, pp. S21–S27, doi: 10.3233/JPD-202100.
[2] J. A. Osborne et al., “Physical Therapist Management of Parkinson Disease: A Clinical Practice Guideline From the American Physical Therapy Association,” Phys Ther, vol. 102, no. 4, p. pzab302, Dec. 2021, doi: 10.1093/ptj/pzab302.
[3] M. R. Rafferty, E. Nettnin, J. G. Goldman, and J. MacDonald, “Frameworks for Parkinson’s Disease Rehabilitation Addressing When, What, and How,” Curr Neurol Neurosci Rep, vol. 21, no. 3, p. 12, Feb. 2021, doi: 10.1007/s11910-021-01096-0.
[4] M. Schenkman et al., “Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease,” JAMA Neurol, vol. 75, no. 2, pp. 219–226, Feb. 2018, doi: 10.1001/jamaneurol.2017.3517.
[5] R. M. Lamont, H. L. Daniel, C. L. Payne, and S. G. Brauer, “Accuracy of wearable physical activity trackers in people with Parkinson’s disease,” Gait and Posture, vol. 63, no. April, pp. 104–108, 2018, doi: 10.1016/j.gaitpost.2018.04.034.
[6] G. Nazari and J. C. MacDermid, “Minimal Detectable Change Thresholds and Responsiveness of Zephyr Bioharness and Fitbit Charge Devices,” The Journal of Strength & Conditioning Research, vol. 34, no. 1, pp. 257–263, Jan. 2020, doi: 10.1519/JSC.0000000000002136.
[7] 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, Oct. 2022, doi: 10.1097/NPT.0000000000000410.
[8] A. D. Speelman, M. van Nimwegen, B. R. Bloem, and M. Munneke, “Evaluation of implementation of the ParkFit program: A multifaceted intervention aimed to promote physical activity in patients with Parkinson’s disease,” Physiotherapy, vol. 100, no. 2, pp. 134–141, Jun. 2014, doi: 10.1016/j.physio.2013.05.003.

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