Clinical outcomes following a home-based dual-task telerehabilitation program in Parkinson's disease

To examine changes in motor and non-motor clinical outcomes following participation in a home-based telerehabilitation program incorporating motor-cognitive dual-task exercises in individuals with Parkinson's disease (PD).

This retrospective cohort study analyzed prospectively recorded clinical data obtained from a government-supported telerehabilitation service implemented at a tertiary physical medicine and rehabilitation center in Istanbul, Türkiye. The study included 60 participants with mild-to-moderate PD (Hoehn and Yahr stages 1-3) who completed a 6-week intervention consisting of 30 supervised sessions (60 min/session, 5 days/week). The program combined motor exercises, cognitive tasks, and integrated dual-task activities delivered through synchronous video-based supervision. Clinical assessments included balance (Berg Balance Scale, Mini-BESTest), balance confidence (Activities-specific Balance Confidence Scale), mobility (Timed Up and Go test), manual dexterity (Nine-Hole Peg Test), quality of life (PD Questionnaire-39), depressive symptoms (Beck Depression Inventory), and self-reported urinary/fecal incontinence.

Post-intervention analyses demonstrated statistically significant improvements in all evaluated outcomes (all p<0.001). Participants showed better balance, mobility, and hand dexterity, accompanied by increased balance confidence and improved gait-related performance. Quality-of-life scores improved, while depressive symptom severity decreased following the intervention. The proportion of participants reporting urinary incontinence declined from 40% to 23%, whereas fecal incontinence decreased from 12% to 2%. Effect size analyses demonstrated moderate-to-large improvements across the primary and key secondary outcomes, with the largest effects observed for depressive symptoms, quality of life, and balance-related performance. No intervention-related adverse events were identified during the study period.

Participation in a remotely supervised, dual-task-based telerehabilitation program was associated with favorable changes across multiple clinical domains in individuals with PD. The findings suggest that home-based telerehabilitation may represent a feasible and clinically relevant rehabilitation approach within routine practice. Given the retrospective nature of the study and the lack of a control group, the observed findings should be considered preliminary. Prospective randomized controlled trials are needed to confirm these findings and evaluate their long-term clinical significance.