Parkinson Disease Telerehabilitation Program (PDTR): a Home-motor Program. A Pilot Study.
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Observational [Patient Registry]

Summary: 
      Parkinson's disease (PD) leads to multifactorial disabilities with consequent social
      restrictions, especially in the COVID-19 era. Continuity of care, especially rehabilitation
      measures, is critical to improve or maintain an adequate QoL for patients. The Parkinson
      Disease Telerehabilitation Program (PDTR) is an individualized home rehabilitation program
      using open-source platforms (OSp).

      The main purpose of this pilot study is to investigate the feasibility of TR in patients with
      PD by using free OS platforms (PDTR PROGRAM).

      The target of this study was to have at least 90% of participants completing the program. To
      complete the program every single patient had to complete at least 80% of the prescribed TR
      sessions.
    

Detailed description: 
      Participants were PD patient afferent to the Neurology ambulatory. Patients underwent an
      initial evaluation (T0) by the neurologist and physiotherapist. During T0, also the level of
      digital literacy was evaluated

      Participants included in the study were separated into three groups based on their residual
      motor skills evaluated by the Short Physical Performance Battery (SPPB).

      Each group corresponded to a Program (Pr). SPPB score between 12 and 10: Pr. A for patients
      with capable motor skills; they were were associated to the TR program A (TrP.A).

      SPPB score between 9 and 7: Pr. B for patients with reduced motor skills; they were were
      associated to the TR program B (TrP.B).

      SPPB score lower than 7: Pr. C for patients who didn't show having sufficient motor skills;
      they were were associated to the telemonitoring program C (TmP.C) without any exercise
      program.

      Patients who were included in TrP.A and TrP.B underwent a TR program using OS platforms for 8
      consecutive weeks.

      OS platforms used are: Zoom, Skype, Google Teams, WhatsApp. The patient was given the
      opportunity to choose the operating system to use based on their knowledge, computer skills
      and ease of use to facilitate the management of the session.

      Patients in TrP.A and TrP.B had to perform at home a tailored exercise program 4 times/week
      for 45-60 minutes.

      Twice a week, the activity was performed with physiotherapist through OSp. A specific
      exercise program for the parkinsonian patients was structured in relation to the individual
      residual motor skills based on the FITT - frequency/intensity/type/time - protocol. Both
      programs, A and B, include multiple exercise: aerobic activities, mobility and stretching
      exercises for upper and lower limbs, global muscle strengthening, balance & motor
      coordination training, start and stop exercises and walking training.

      The exercises in program A were more complex and showed a higher intensity, while those in
      program B were simpler, safer and at lower intensity.

      Subjects included in TmP.C participated in an 8-weeks program. A video-call was scheduled
      once a week to monitor the patient's clinical condition without any exercise program.

      The target of this study was to have at least 90% of participants completing the program. To
      complete the program every single patient had to complete at least 80% of the prescribed TR
      sessions.
    

Intervention name(s): Telerehabilitation with open source platforms
Intervention type(s): Other
Intervention description(s): Telerehabilitation with opensource platforms. Patients enrolled were dived into three groups based on their score in SPPB. Each group corresponded to a Program (Pr): • Pr. A is for patients with capable motor skills, Pr. B is for patients with reduced motor skills, • Pr. C is for patients who didn't show having sufficient motor skills to support a TR program. Patients who were included in TrP.A and TrP.B underwent a TR program using OS platforms for 8 consecutive weeks. A specific exercise program for the parkinsonian patients was structured in relation to the individual residual motor skills based on the FITT - frequency/intensity/type/time - protocol.
Twice a week, the activity was performed with the support of a physiotherapist through OS TR platform.
Subjects included in TmP.C participated in an 8-weeks program. A video-call was scheduled once a week to monitor the patient's clinical condition without any exercise program.
Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        Parkinson's disease patients with different residual motor skills.
      
Keywords: Parkinson's Disease; Telerehabilitation; Remote Physical Activity; Rehabilitation; Digital Health