The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson’s disease: A pilot study (Preprint)

Abstract

Bradykinesia and rigidity are prototypical motor impairments of Parkinson’s disease highly influencing everyday life. Exercise training is an effective treatment alternative for motor symptoms, complementing dopaminergic medication. High frequency training is necessary to yield clinically relevant improvements. Exercise programs need to be tailored to individual symptoms and integrated in patients’ everyday life. Due to the COVID-19 pandemic, exercise groups in outpatient setting were largely reduced. Developing remotely supervised solutions is therefore of significant importance.

Aim of this pilot study was to evaluate a digital, home-based, high frequency exercise program for PD patients.

15 patients with PD received four weeks of personalized exercise at home using a smartphone-app, remotely supervised by specialized therapists. Exercises were chosen based on the patient-defined motor impairment. Intervention effects were evaluated using the Unified Parkinson Disease Rating Scale, part III (UPDRS-III), standardized sensor-based gait analysis, Timed Up and Go Test (TUG), 2-Minute-Walk-Test, quality of life (PDQ-39), and patient-defined motor tasks of daily living. Usability of the smartphone-app was assessed by System-Usability-Scale (SUS).

Motor symptoms rated by UPDRS-III improved by 14 %, mobility-related QoL by 14 %, and QoL regarding social support by 19 %, however each without reaching significance level. Patient-defined motor tasks of daily living significantly improved in 13 out of 15 patients by 40 % on average. Changes of sensor-based gait parameters or functional gait tests were not observed. The SUS reached an average score of 72.2 ± 6.5 indicating good usability of the smartphone-app.

This pilot study presented that a tailored, digital, home-based, and high frequency exercise program over four weeks improved patient-defined motor activities of daily life based on a self-developed patient-defined impairment score indicating that digital exercise concepts may have the potential to beneficially impact motor symptoms of daily living. Future studies should investigate sustainability effects in controlled study designs conducted over a longer period of time.