TY - JOUR
T1 - The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson’s disease
T2 - a long-term feasibility study
AU - Lützow, Lisa
AU - Teckenburg, Isabelle
AU - Koch, Veronika
AU - Marxreiter, Franz
AU - Jukic, Jelena
AU - Stallforth, Sabine
AU - Regensburger, Martin
AU - Winkler, Jürgen
AU - Klucken, Jochen
AU - Gaßner, Heiko
N1 - This work was supported by the Fraunhofer Internal Programs under grant Attract 044–602140 and 044–602150. Further, this work was (partly) funded by the Deutsche Forschungsgemeinschaft (German Research Foundation)—SFB 1483—Project-ID 442419336, EmpkinS, and “Mobility_APP” grant 438496663.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/10/23
Y1 - 2023/10/23
N2 - Background: Exercise therapy is considered effective for the treatment of motor impairment in patients with Parkinson’s disease (PD). During the COVID-19 pandemic, training sessions were cancelled and the implementation of telerehabilitation concepts became a promising solution. The aim of this controlled interventional feasibility study was to evaluate the long-term acceptance and to explore initial effectiveness of a digital, home-based, high-frequency exercise program for PD patients. Training effects were assessed using patient-reported outcome measures combined with sensor-based and clinical scores. Methods: 16 PD patients (smartphone group, SG) completed a home-based, individualized training program over 6–8 months using a smartphone app, remotely supervised by a therapist, and tailored to the patient’s motor impairments and capacity. A control group (CG, n = 16) received medical treatment without participating in digital exercise training. The usability of the app was validated using System Usability Scale (SUS) and User Version of the Mobile Application Rating Scale (uMARS). Outcome measures included among others Unified Parkinson Disease Rating Scale, part III (UPDRS-III), sensor-based gait parameters derived from standardized gait tests, Parkinson’s Disease Questionnaire (PDQ-39), and patient-defined motor activities of daily life (M-ADL). Results: Exercise frequency of 74.5% demonstrated high adherence in this cohort. The application obtained 84% in SUS and more than 3.5/5 points in each subcategory of uMARS, indicating excellent usability. The individually assessed additional benefit showed at least 6 out of 10 points (Mean = 8.2 ± 1.3). From a clinical perspective, patient-defined M-ADL improved for 10 out of 16 patients by 15.5% after the training period. The results of the UPDRS-III remained stable in the SG while worsening in the CG by 3.1 points (24%). The PDQ-39 score worsened over 6–8 months by 83% (SG) and 59% (CG) but the subsection mobility showed a smaller decline in the SG (3%) compared to the CG (77%) without reaching significance level for all outcomes. Sensor-based gait parameters remained constant in both groups. Conclusions: Long-term training over 6–8 months with the app is considered feasible and acceptable, representing a cost-effective, individualized approach to complement dopaminergic treatment. This study indicates that personalized, digital, high-frequency training leads to benefits in motor sections of ADL and Quality of Life.
AB - Background: Exercise therapy is considered effective for the treatment of motor impairment in patients with Parkinson’s disease (PD). During the COVID-19 pandemic, training sessions were cancelled and the implementation of telerehabilitation concepts became a promising solution. The aim of this controlled interventional feasibility study was to evaluate the long-term acceptance and to explore initial effectiveness of a digital, home-based, high-frequency exercise program for PD patients. Training effects were assessed using patient-reported outcome measures combined with sensor-based and clinical scores. Methods: 16 PD patients (smartphone group, SG) completed a home-based, individualized training program over 6–8 months using a smartphone app, remotely supervised by a therapist, and tailored to the patient’s motor impairments and capacity. A control group (CG, n = 16) received medical treatment without participating in digital exercise training. The usability of the app was validated using System Usability Scale (SUS) and User Version of the Mobile Application Rating Scale (uMARS). Outcome measures included among others Unified Parkinson Disease Rating Scale, part III (UPDRS-III), sensor-based gait parameters derived from standardized gait tests, Parkinson’s Disease Questionnaire (PDQ-39), and patient-defined motor activities of daily life (M-ADL). Results: Exercise frequency of 74.5% demonstrated high adherence in this cohort. The application obtained 84% in SUS and more than 3.5/5 points in each subcategory of uMARS, indicating excellent usability. The individually assessed additional benefit showed at least 6 out of 10 points (Mean = 8.2 ± 1.3). From a clinical perspective, patient-defined M-ADL improved for 10 out of 16 patients by 15.5% after the training period. The results of the UPDRS-III remained stable in the SG while worsening in the CG by 3.1 points (24%). The PDQ-39 score worsened over 6–8 months by 83% (SG) and 59% (CG) but the subsection mobility showed a smaller decline in the SG (3%) compared to the CG (77%) without reaching significance level for all outcomes. Sensor-based gait parameters remained constant in both groups. Conclusions: Long-term training over 6–8 months with the app is considered feasible and acceptable, representing a cost-effective, individualized approach to complement dopaminergic treatment. This study indicates that personalized, digital, high-frequency training leads to benefits in motor sections of ADL and Quality of Life.
UR - http://www.scopus.com/inward/record.url?scp=85175500524&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/37902922
U2 - 10.1186/s41687-023-00631-6
DO - 10.1186/s41687-023-00631-6
M3 - Article
C2 - 37902922
AN - SCOPUS:85175500524
SN - 2509-8020
VL - 7
JO - Journal of Patient-Reported Outcomes
JF - Journal of Patient-Reported Outcomes
IS - 1
M1 - 106
ER -