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Home-based exercise monitored with telehealth is feasible and acceptable compared to centre-based exercise in
Allyson Flynn1,2, Elisabeth Preston2, Sarah Dennis1,3,4
1Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
Objectives:
To investigate the feasibility and acceptability of a home-based exercise program monitored using telehealth for people with Parkinson's disease.
Design:
Pilot randomised control trial.
Setting:
University physiotherapy clinic, participants' homes.
Participants:
Forty people with mild to moderate Parkinson's disease, mean age 72 (6.9).
Intervention:
In Block 1 (5 weeks) all participants completed predominantly centre-based exercise plus a self-management program. Participants were then randomised to continue the centre-based exercise (n = 20) or to a home-based program with telehealth (n = 20) for Block 2 (5 weeks). The exercises targeted balance and gait.
Outcomes:
The primary outcomes were the feasibility and acceptability of the intervention. Secondary outcomes were balance, gait speed and freezing of gait.
Results:
Adherence was high in Block 1 (93%), and Block 2 (centre-based group = 93%, home-based group = 84%). In Block 2, the physiotherapist spent 6.4 hours providing telehealth to the home-based group (mean 10 (4) minutes per participant) and 32.5 hours delivering the centre-based exercise classes (98 minutes per participant). Participants reported that exercise was helpful, they could follow the home program and they would recommend exercising at home or in a group. However, exercising at home was less satisfying and there was a mixed response to the acceptability of the self-management program. There was no difference between groups in any of the secondary outcome measures (preferred walking speed mean difference -0.04 (95% CI: -0.12 to 0.05).
Conclusion:
Home-based exercise monitored using telehealth for people with Parkinson's disease is feasible and acceptable.
