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Physical Activity Coaching via Telehealth for People With Parkinson Disease: A Cohort Study
Hai-Jung Steffi Shih1, Chelsea E Macpherson, Miriam King
1Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (H.J.S.S., C.E.M., M.K., Y.G., A.S., L.Q.); Departments of Neurology (E.D., H.S., R.N.A.) and Rehabilitation and Regenerative Medicine (Physical Therapy) (L.Q.), Columbia University Irving Medical Center, New York, New York; Department of Occupational Therapy, San Jose State University, San Jose, California (K.L.); Department of Rehabilitation (Physical Therapy), New York Presbyterian Hospital, New York, New York (J.R., G.Y.); Doctor of Physical Therapy Program, Marist College, Poughkeepsie, New York (J.F.); and Department of Neuroscience, Barnard College of Columbia University, New York, New York (J.R.).
Background And Purpose:
Physical activity (PA) has many known benefits for people with Parkinson disease (PD); however, many people do not meet recommended levels of frequency or intensity. 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 in people with Parkinson disease. This study aimed to determine the feasibility and preliminary efficacy of Engage-PD, and to explore whether baseline characteristics were associated with outcomes.
Methods:
A single cohort of people with PD (n = 62, Hoehn and Yahr I-III) participated in the 3-month Engage-PD program, which consisted of up to 5 telehealth coaching sessions delivered by physical therapists. Feasibility was evaluated based on recruitment and retention rates, along with participants' feedback. Planned and unplanned PA, exercise self-efficacy (ESE), and individualized goals were assessed pre- and post-intervention. Relationships between baseline characteristics and changes in planned PA and ESE were also evaluated.
Results:
Recruitment (62%) and retention (85%) rates were high, and the intervention was well accepted and perceived by the participants. From pre- to postintervention, participants increased planned PA (d = 0.33), ESE (d = 1.20), and individualized goal performance (d = 1.63) and satisfaction (d = 1.70). Participants with lower baseline planned PA experienced greater improvements in planned PA, and those with lower baseline ESE experienced greater improvements in ESE.
Discussion And Conclusions:
A telehealth PA coaching program for people with PD was feasible and potentially efficacious. Physical therapist-led coaching may be an important component of a consultative model of care starting early in the disease process.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A393).
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