Feasibility, Safety, and Effectiveness of Telerehabilitation in Mild-to-Moderate Parkinson's Disease

Edoardo Bianchini, Camilla Onelli, Carmen Morabito, Marika Alborghetti, Domiziana Rinaldi, Paolo Anibaldi, Adriano Marcolongo, Marco Salvetti, Francesco E Pontieri, Edoardo Bianchini, Camilla Onelli, Carmen Morabito, Marika Alborghetti, Domiziana Rinaldi, Paolo Anibaldi, Adriano Marcolongo, Marco Salvetti, Francesco E Pontieri

Abstract

Introduction: Parkinson's disease (PD) patients frequently engage in rehabilitation to ameliorate symptoms. During the Coronavirus disease 2019 (COVID-19) pandemic, access to rehabilitation programs has been markedly limited, consequently, telerehabilitation gained popularity. In this prospective, open-label, and pilot study, we aimed to investigate feasibility, safety, and efficacy of telerehabilitation in mild-to-moderate PD patients.

Materials and methods: Twenty-three PD patients, with Hoehn and Yahr stage <3, without gait disturbances or dementia and capable of using the televisit platform, were recruited for a 5-week telerehabilitation program, consisting of 1 remote visit with a therapist and a minimum of two sessions of >30-min of self-conducted exercises per week. Patients received video tutorials of exercises and were asked to keep a diary of sessions. At baseline (T0), at the end of the intervention (T1), and 1 month after the end of treatment (T2), patients were remotely assessed with MDS-UPDRS part I-III, PDQ-39, Functional Independence Measure (FIM), and Frontal Assessment Battery scales, respectively. Acceptable compliance to the program was defined as >60% matching of frequency and duration of sessions, whereas optimal compliance was set at >80% matching.

Results: The dropout rate was 0%. Over 85% of patients reached acceptable adherence cut-off and around 70% reached optimal one. No adverse events were reported during sessions. The repeated measure analysis of variance (rANOVA) showed a significant effect of factor "time" for MDS-UPDRS-III (p < 0.0001) with a mean reduction of 4.217 points between T0 and T1 and return to baseline at T2. No significant effect was found for other outcome measures.

Conclusion: Our findings demonstrate that telerehabilitation is safe, feasible, and effective on motor symptoms in mild-to-moderate PD patients.

Keywords: Parkinson's disease; neurorehabilitation; physiotherapy; remote treatment; telehealth; telemedicine; telerehabilitation.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Bianchini, Onelli, Morabito, Alborghetti, Rinaldi, Anibaldi, Marcolongo, Salvetti and Pontieri.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Histogram showing the MDS-UPDRS-III score across time points. Standard error of the mean is shown by vertical bars. Statistically significant differences are marked with an asterisk. The post-hoc analysis showed a reduction between T0 and T1 and a return to baseline at T2.

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