Home-based exercise monitored with telehealth is feasible and acceptable compared to centre-based exercise in Parkinson's disease: A randomised pilot study.

Flynn, Allyson; Preston, Elisabeth; Dennis, Sarah; Canning, Colleen G; Allen, Natalie E

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.