Using Implementation Frameworks to Provide Proactive Physical Therapy for People With Parkinson Disease: Case Report

Area of Science:

• Neurology
• Rehabilitation Medicine
• Public Health

Background:

• European guidelines advocate for early physical therapy in Parkinson disease (PD) for education and intervention.
• Current practice often delays physical therapy until gait and balance issues arise, missing a crucial window for proactive care.

Purpose of the Study:

• To present the application of a proactive physical therapy (PAPT) approach for individuals with Parkinson disease (PD).
• To utilize implementation frameworks to guide the process, identify success factors, and evaluate the implementation of PAPT.

Main Methods:

• The PAPT program targeted individuals with PD before significant mobility decline in an outpatient setting.
• Implementation utilized the Knowledge-to-Action and Consolidated Framework for Implementation Research.
• The RE-AIM framework and mixed methods were employed for program evaluation.

Main Results:

• In the first year, 20 participants completed the 6-month PAPT program evaluation.
• Regular participation in aerobic, strengthening, and flexibility exercises approximately doubled; balance activity engagement increased significantly.
• Participants reported a median of 140 minutes of weekly aerobic exercise and experienced physical and emotional benefits.

Conclusions:

• Implementation frameworks facilitated the successful application and evaluation of a PAPT delivery model.
• The PAPT approach effectively enhanced and sustained independent exercise participation in individuals with Parkinson disease.