Tele-rehabilitation-based exercise in Parkinson’s disease: A pilot study of feasibility and preliminary outcomes

Abstract

This pilot study examined the feasibility and preliminary effects of two exercise programs delivered via tele-rehabilitation in individuals with Parkinson's disease (PD). Twelve individuals with PD, previously allocated to two groups in a prior face-to-face study, re-engaged in the same protocols remotely. Group 1 received a conventional exercise program (CEP) combined with cervical stabilization exercise (CSE), and Group 2 received the CEP alone. Both programs were delivered via synchronous video-based tele-rehabilitation (one 60-minute session per week for eight weeks). The following outcomes were assessed pre- and post-intervention: Unified Parkinson's Disease Rating Scale (UPDRS), visual analog scale, Short Form 36 (SF-36), 30-second chair stand test (30s-CST), static standing test, Fear of COVID-19 Scale, Beck Anxiety Inventory, Beck Depression Inventory, and ACTIVLIM Scale. Both groups showed pre-to-post improvements in total UPDRS scores, the mental health and vitality subdomains of the SF-36, 30s-CST performance, single-limb stance and depressive symptoms (p<0.05). Group 2 also showed improvement in UPDRS-II, bodily pain, social functioning, health transition, tandem stance, and anxiety (p<0.05). Group 1 exhibited numerically greater pre-to-post changes in UPDRS-III, the SF 36 mental health and role limitation subdomains, functional performance, balance, pandemic related fear and activity limitations, with large effect sizes observed for selected parameters (Cohen's d>0.80). Tele-rehabilitation appears to be a feasible and well-tolerated mode of exercise delivery for individuals with PD, and was associated with improvements across multiple outcomes. Our preliminary findings suggest that integrating CSE into remote rehabilitation programs may offer additional benefit, but they should be supported in adequately powered trials.