Effectiveness of Telerehabilitation on Motor Impairments, Non-motor Symptoms and Compliance in Patients With Parkinson's Disease: A Systematic Review

Chiara Vellata, Stefano Belli, Francesca Balsamo, Andrea Giordano, Roberto Colombo, Giorgio Maggioni, Chiara Vellata, Stefano Belli, Francesca Balsamo, Andrea Giordano, Roberto Colombo, Giorgio Maggioni

Abstract

Introduction: Parkinson's disease (PD) is a chronic neurodegenerative disease involving a progressive alteration of the motor and non-motor function. PD influences the patient's daily living and reduces participation and quality of life in all phases of the disease. Early physical exercise can mitigate the effects of symptoms but access to specialist care is difficult. With current technological progress, telemedicine, and telerehabilitation is now a viable option for managing patients, although few studies have investigated the use of telerehabilitation in PD. In this systematic review, was investigated whether telerehabilitation leads to improvements in global or specific motor tasks (gait and balance, hand function) and non-motor dysfunction (motor speech disorder, dysphagia). The impact of TR on quality of life and patient satisfaction, were also assessed. The usage of telerehabilitation technologies in the management of cognitive impairment was not addressed. Method: An electronic database search was performed using the following databases: PubMed/MEDLINE, COCHRANE Library, PEDro, and SCOPUS for data published between January 2005 and December 2019 on the effects of telerehabilitation systems in managing motor and non-motor symptoms. This systematic review was conducted in accordance with the PRISMA guideline and was registered in the PROSPERO database (CRD42020141300). Results: A total of 15 articles involving 421 patients affected by PD were analyzed. The articles were divided into two categories based on their topic of interest or outcome. The first category consisted of the effects of telerehabilitation on gait and balance (3), dexterity of the upper limbs (3), and bradykinesia (0); the second category regarded non-motor symptoms such as speech disorders (8) and dysphagia (0). Quality of life (7) and patient satisfaction (8) following telerehabilitation programs were also analyzed, as well as feasibility and costs. Conclusion: Telerehabilitation is feasible in people affected by PD. Our analysis of the available data highlighted that telerehabilitation systems are effective in maintaining and/or improving some clinical and non-clinical aspects of PD (balance and gait, speech and voice, quality of life, patient satisfaction). Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier: CRD42020141300.

Keywords: Parkinson's disease; digital health; online rehabilitation; remote physical activity; review; 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 © 2021 Vellata, Belli, Balsamo, Giordano, Colombo and Maggioni.

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Flow chart.

References

    1. De Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol. (2006) 5:525–35. 10.1016/S1474-4422(06)70471-9
    1. Balestrino R, Schapira AHV. Parkinson disease. Europ J Neurol. (2020) 27:27–42. 10.1111/ene.14108
    1. Nussbaum RL, Ellis CE. Alzheimer's disease and Parkinson's disease. N Engl J Med. (2003) 348:1356–64. 10.1056/NEJM2003ra020003
    1. Lee A, Gilbert RM. Epidemiology of Parkinson disease. Neurol Clin. (2016) 34:955–65. 10.1016/j.ncl.2016.06.012
    1. Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: a systematic review and meta-analysis. Move Disord. (2014) 29:1583–90. 10.1002/mds.25945
    1. von Campenhausen S, Bornschein B, Wick R, Bötzel K, Sampaio C, Poewe W, et al. . Prevalence and incidence of Parkinson's disease in Europe. Europ Neuropsychopharmacol. (2005) 15:473–90. 10.1016/j.euroneuro.2005.04.007
    1. Gillies GE, Pienaar IS, Vohra S, Qamhawi Z. Sex differences in Parkinson's disease. Front Neuroendocrinol. (2014) 35:370–84. 10.1016/j.yfrne.2014.02.002
    1. Albiol Pérez S, Gil-Gómez JA, Gil-Gómez H, Muñoz-Tomás MT, Vial-Escolano R, Lozano-Quilis JA. The Effect of balance training on postural control in patients with Parkinson's disease using a virtual rehabilitation system. Methods Inf Med. (2017) 56:138–44. 10.3414/ME16-02-0004
    1. Fahn S. Description of Parkinson's disease as a clinical syndrome. Ann N Y Acad Sci. (2003) 991:1–4. 10.1111/j.1749-6632.2003.tb07458.x
    1. Chaudhuri KR, Odin P, Antonini A, Martinez-Martin P. Parkinson's disease: the non-motor issues. Parkinsonism Relat Disord. (2011) 17:717–23. 10.1016/j.parkreldis.2011.02.018
    1. Schapira AH, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. (2017) 18:435. 10.1038/nrn.2017.62
    1. Pinto S, Cardoso R, Sadat J, Guimarães I, Mercier C, Santos H, et al. . Dysarthria in individuals with Parkinson's disease: a protocol for a binational, cross-sectional, case-controlled study in French and European Portuguese (FraLusoPark). BMJ Open. (2016) 6:e012885. 10.1136/bmjopen-2016-012885
    1. Matsubara T, Suzuki K, Fujita H, Watanabe Y, Sakuramoto H, Matsubara M, et al. . Autonomic symptoms correlate with non-autonomic non-motor symptoms and sleep problems in patients with Parkinson's disease. Europ Neurol. (2018) 80:193–9. 10.1159/000495797
    1. Salat-Foix D, Suchowersky O. The management of gastrointestinal symptoms in Parkinson's disease. Expert Rev Neurotherap. (2012) 12:239–48. 10.1586/ern.11.192
    1. Blackett H, Walker R, Wood B. Urinary dysfunction in Parkinson's disease: a review. Parkinsonism Relat Disord. (2009) 15:81–7. 10.1016/j.parkreldis.2007.10.016
    1. Goldstein DS, Holmes C, Li ST, Bruce S, Metman LV, Cannon RO, III. Cardiac sympathetic denervation in Parkinson disease. Ann Internal Med. (2000) 133:338–47. 10.7326/0003-4819-133-5-200009050-00009
    1. Ondo WG, Vuong KD, Khan H, Atassi F, Kwak C, Jankovic J. Daytime sleepiness and other sleep disorders in Parkinson's disease. Neurology. (2001) 57:1392–6. 10.1212/WNL.57.8.1392
    1. Nolano M, Provitera V, Estraneo A, Selim MM, Caporaso G, Stancanelli A, et al. . Sensory deficit in Parkinson's disease: evidence of a cutaneous denervation. Brain. (2008) 131:1903–11. 10.1093/brain/awn102
    1. Lin CH, Lin JW, Liu YC, Chang CH, Wu RM. Risk of Parkinson's disease following anxiety disorders: a nationwide population-based cohort study. Europ J Neurol. (2015) 22:1280–7. 10.1111/ene.12740
    1. Marin RS, Fogel BS, Hawkins J, Duffy J, Krupp B. Apathy: a treatable syndrome. J Neuropsychiat Clin Neurosci. (1995) 7:23–30. 10.1176/jnp.7.1.23
    1. Weintraub D, Moberg PJ, Duda JE, Katz IR, Stern MB. Effect of psychiatric and other nonmotor symptoms on disability in Parkinson's disease. J Am Geriatrics Soc. (2004) 52:784–8. 10.1111/j.1532-5415.2004.52219.x
    1. Nombela C, Bustillo PJ, Castell P, Medina V, Herrero MT. Cognitive rehabilitation in Parkinson's disease: evidence from neuroimaging. Front Neurol. (2011) 2:82. 10.3389/fneur.2011.00082
    1. Jankovic J, Aguilar LG. Current approaches to the treatment of Parkinson's disease. Neuropsychiatric Dis Treat. (2008) 4:743. 10.2147/NDT.S2006
    1. Magrinelli F, Picelli A, Tocco P, Federico A, Roncari L, Smania N, et al. . Pathophysiology of motor dysfunction in Parkinson's disease as the rationale for drug treatment and rehabilitation. Parkinson's Dis. (2016) 2016:9832839. 10.1155/2016/9832839
    1. Geroin C, Gandolfi M, Bruno V, Smania N, Tinazzi M. Integrated approach for pain management in Parkinson disease. Curr Neurol Neurosci Rep. (2016) 16:28. 10.1007/s11910-016-0628-7
    1. Oguh O, Eisenstein A, Kwasny M, Simuni T. Back to the basics: regular exercise matters in Parkinson's disease: results from the National Parkinson Foundation QII registry study. Parkinsonism Related Disord. (2014) 20:1221–5. 10.1016/j.parkreldis.2014.09.008
    1. Grazina R, Massano J. Physical exercise and Parkinson's disease: influence on symptoms, disease course and prevention. Rev Neurosci. (2013) 24:139–52. 10.1515/revneuro-2012-0087
    1. Pachoulakis I, Xilourgos N, Papadopoulos N, Analyti A. A Kinect-based physiotherapy and assessment platform for Parkinson's disease patients. J Med Engin. (2016) 2016:2795090. 10.1155/2016/9413642
    1. Barbour PJ, Arroyo J, High S, Fichera LB, Staska-Pier MM, McMahon MK. Telehealth for patients with Parkinson's disease: delivering efficient and sustainable long-term care. Hosp Pract. (2016) 44:92–7. 10.1080/21548331.2016.1166922
    1. Bphty MN, Boccthy LT, Boccthy AV. Internet-based physical assessment of people with Parkinson disease is accurate and reliable: a pilot study. J Rehabil Res Dev. (2013) 50:643. 10.1682/JRRD.2012.08.0148
    1. Intzandt B, Beck EN, Silveira CR. The effects of exercise on cognition and gait in Parkinson's disease: a scoping review. Neurosci Biobehav Rev. (2018) 95:136–69. 10.1016/j.neubiorev.2018.09.018
    1. Linares-del Rey M, Vela-Desojo L, Cano-de la Cuerda R. Mobile phone applications in Parkinson's disease: a systematic review. Neurología. (2019) 34:38–54. 10.1016/j.nrleng.2018.12.002
    1. Ben-Pazi H, Browne P, Chan P, Cubo E, Guttman M, Hassan A, et al. . The promise of telemedicine for movement disorders: an interdisciplinary approach. Curr Neurol Neurosci Rep. (2018) 18:26. 10.1007/s11910-018-0834-6
    1. Achey MA, Beck CA, Beran DB, Boyd CM, Schmidt PN, Willis AW, et al. . Virtual house calls for Parkinson disease (Connect. Parkinson): study protocol for a randomized, controlled trial. Trials. (2014) 15:1–3. 10.1186/1745-6215-15-465
    1. Gregory P, Alexander J, Satinsky J. Clinical telerehabilitation: applications for physiatrists. PM&R. (2011) 3:647–56. 10.1016/j.pmrj.2011.02.024
    1. Agostini M, Moja L, Banzi R, Pistotti V, Tonin P, Venneri A, et al. . Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. J Telemed Telecare. (2015) 21:202–13. 10.1177/1357633X15572201
    1. McCue M, Fairman A, Pramuka M. Enhancing quality of life through telerehabilitation. Phys Med Rehabil Clin. (2010) 21:195–205. 10.1016/j.pmr.2009.07.005
    1. Hailey D, Roine R, Ohinmaa A, Dennett L. Evidence of benefit from telerehabilitation in routine care: a systematic review. J Telemed Telecare. (2011) 17:281–7. 10.1258/jtt.2011.101208
    1. Galea MD. Telemedicine in rehabilitation. Phys Med Rehabil Clin. (2019) 30:473–83. 10.1016/j.pmr.2018.12.002
    1. Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS. Telerehabilitation: review of the state-of-the-art and areas of application. JMIR Rehabil Assistive Technol. (2017) 4:e7. 10.2196/rehab.7511
    1. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?. Age Ageing. (2006) 35(suppl_2):ii7–11. 10.1093/ageing/afl077
    1. Gandolfi M, Geroin C, Dimitrova E, Boldrini P, Waldner A, Bonadiman S, et al. . Virtual reality telerehabilitation for postural instability in Parkinson's disease: a multicenter, single-blind, randomized, controlled trial. BioMed Res Int. (2017) 2017:7962826. 10.1155/2017/7962826
    1. Piron L, Turolla A, Tonin P, Piccione F, Lain L, Dam M. Satisfaction with care in post-stroke patients undergoing a telerehabilitation programme at home. J Telemed Telecare. (2008) 14:257–60. 10.1258/jtt.2008.080304
    1. Giansanti D, Tiberi Y, Silvestri G, Maccioni G. Toward the integration of novel wearable step-counters in gait telerehabilitation after stroke. Telemed e-Health. (2009) 15:105–11. 10.1089/tmj.2008.0051
    1. Hermens H, Huijgen B, Giacomozzi C, Ilsbroukx S, Macellari V, Prats E, et al. . Clinical assessment of the HELLODOC tele-rehabilitation service. Ann Ist Super Sanita. (2008) 44:154–63.
    1. Amatya B, Galea MP, Kesselring J, Khan F. Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: a systematic review. Multiple Sclerosis Relat Disord. (2015) 4:358–69. 10.1016/j.msard.2015.06.011
    1. Robb JF, Hyland MH, Goodman AD. Comparison of telemedicine versus in-person visits for persons with multiple sclerosis: a randomized crossover study of feasibility, cost, and satisfaction. Multiple Sclerosis Relat Disord. (2019) 36:101258. 10.1016/j.msard.2019.05.001
    1. Piotrowicz E, Piotrowicz R. Cardiac telerehabilitation: current situation and future challenges. Europ J Prevent Cardiol. (2013) 20(2_suppl):12–16. 10.1177/2047487313487483c
    1. Tousignant M, Boissy P, Moffet H, Corriveau H, Cabana F, Marquis F, et al. . Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Telemed e-Health. (2011) 17:376–82. 10.1089/tmj.2010.0198
    1. Palacín-Marín F, Esteban-Moreno B, Olea N, Herrera-Viedma E, Arroyo-Morales M. Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care. Spine. (2013) 38:947–52. 10.1097/BRS.0b013e318281a36c
    1. Pani D, Piga M, Barabino G, Crabolu M, Uras S, Mathieu A, et al. . Home tele-rehabilitation for rheumatic patients: impact and satisfaction of care analysis. J Telemed Telecare. (2017) 23:292–300. 10.1177/1357633X16632950
    1. Finkelstein J, Lapshin O, Castro H, Cha E, Provance PG. Home-based physical telerehabilitation in patients with multiple sclerosis: a pilot study. J Rehabil Res Dev. (2008) 45:1361–73. 10.1682/JRRD.2008.01.0001
    1. Marshall SG, Shaw DK, Honles GL, Sparks KE. Interdisciplinary approach to the rehabilitation of an 18-year-old patient with bronchopulmonary dysplasia, using telerehabilitation technology. Respirat Care. (2008) 53:346–50.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. (2009) 6:e1000097. 10.1371/journal.pmed.1000097
    1. Seidler KJ, Duncan RP, McNeely ME, Hackney ME, Earhart GM. Feasibility and preliminary efficacy of a telerehabilitation approach to group adapted tango instruction for people with Parkinson disease. J Telemed Telecare. (2017) 23:740–6. 10.1177/1357633X16668092
    1. Cikajlo I, Hukić A, Dolinšek I, Zajc D, Vesel M, Krizmanič T, et al. . Can telerehabilitation games lead to functional improvement of upper extremities in individuals with Parkinson's disease?. Int J Rehabil Res. (2018) 41:230. 10.1097/MRR.0000000000000291
    1. Hoffmann T, Russell T, Thompson L, Vincent A, Nelson M. Using the internet to assess activities of daily living and hand function in people with Parkinson's disease. NeuroRehabilitation. (2008) 23:253–61. 10.3233/NRE-2008-23307
    1. Constantinescu G, Theodoros D, Russell T, Ward E, Wilson S, Wootton R. Assessing disordered speech and voice in Parkinson's disease: a telerehabilitation application. Int J Lang Commun Disord. (2010) 45:630–44. 10.3109/13682820903470569
    1. Constantinescu G, Theodoros D, Russell T, Ward E, Wilson S, Wootton R. Treating disordered speech and voice in Parkinson's disease online: a randomized controlled non-inferiority trial. Int J Lang Commun Disord. (2011) 46:1–16. 10.3109/13682822.2010.484848
    1. Theodoros DG, Hill AJ, Russell TG. Clinical and quality of life outcomes of speech treatment for Parkinson's disease delivered to the home via telerehabilitation: a noninferiority randomized controlled trial. Am J Speech-Lang Pathol. (2016) 25:214–32. 10.1044/2015_AJSLP-15-0005
    1. Wilkinson JR, Spindler M, Wood SM, Marcus SC, Weintraub D, Morley JF, et al. . High patient satisfaction with telehealth in Parkinson disease: a randomized controlled study. Neurology. (2016) 6:241–51. 10.1212/CPJ.0000000000000252
    1. Griffin M, Bentley J, Shanks J, Wood C. The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: a non-inferiority study. J Telemed Telecare. (2018) 24:209–15. 10.1177/1357633X17691865
    1. Chatto CA, York PT, Slade CP, Hasson SM. Use of a telehealth system to enhance a home exercise program for a person with Parkinson disease: a case report. J Neurol Phys Ther. (2018) 42:22–9. 10.1097/NPT.0000000000000209
    1. Constantinescu GA, Theodoros DG, Russell TG, Ward EC, Wilson SJ, Wootton R. Home-based speech treatment for Parkinson's disease delivered remotely: a case report. J Telemed Telecare. (2010) 16:100–4. 10.1258/jtt.2009.090306
    1. Hill AJ, Theodoros DG, Russell TG, Cahill LM, Ward EC, Clark KM. An Internet-based telerehabilitation system for the assessment of motor speech disorders: a pilot study. Am J Speech Lang Pathol. (2006) 15:45–56. 10.1044/1058-0360(2006/006)
    1. Howell S, Tripoliti E, Pring T. Delivering the Lee Silverman Voice Treatment (LSVT) by web camera: a feasibility study. Int J Lang Commun Disord. (2009) 44:287–300. 10.1080/13682820802033968
    1. Quinn R, Park S, Theodoros D, Hill AJ. Delivering group speech maintenance therapy via telerehabilitation to people with Parkinson's disease: a pilot study. Int J Speech-Lang Pathol. (2019) 21:385–94. 10.1080/17549507.2018.1476918
    1. Siegert C, Hauptmann B, Jochems N, Schrader A, Deck R. ParkProTrain: an individualized, tablet-based physiotherapy training programme aimed at improving quality of life and participation restrictions in PD patients–a study protocol for a quasi-randomized, longitudinal and sequential multi-method study. BMC Neurol. (2019) 19:1–9. 10.1186/s12883-019-1355-x
    1. Ramig L, Halpern A, Spielman J, Fox C, Freeman K. Speech treatment in Parkinson's disease: randomized controlled trial (RCT). Move Disord. (2018) 33:1777–91. 10.1002/mds.27460
    1. Ramig LO, Countryman S, O'Brien C, Hoehn M, Thompson L. Intensive speech treatment for patients with Parkinson's disease: short-and long-term comparison of two techniques. Neurology. (1996) 47:1496–504. 10.1212/WNL.47.6.1496
    1. Jenkinson C, Fitzpatrick RAY, Peto VIV, Greenhall R, Hyman N. The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. Age Ageing. (1997) 26:353–7. 10.1093/ageing/26.5.353
    1. Cai G, Huang Y, Luo S, Lin Z, Dai H, Ye Q. Continuous quantitative monitoring of physical activity in Parkinson's disease patients by using wearable devices: a case-control study. Neurol Sci. (2017) 38:1657–63. 10.1007/s10072-017-3050-2
    1. Dorsey ER, Deuel LM, Voss TS, Finnigan K, George BP, Eason S, et al. . Increasing access to specialty care: a pilot, randomized controlled trial of telemedicine for Parkinson's disease. Move Disord. (2010) 25:1652–9. 10.1002/mds.23145
    1. Dorsey ER, Venkataraman V, Grana MJ, Bull MT, George BP, Boyd CM, et al. . Randomized controlled clinical trial of “virtual house calls” for Parkinson disease. JAMA Neurol. (2013) 70:565–70. 10.1001/jamaneurol.2013.123
    1. Dorsey ER, Achey MA, Beck CA, Beran DB, Biglan KM, Boyd CM, et al. . National randomized controlled trial of virtual house calls for people with Parkinson's disease: interest and barriers. Telemed e-Health. (2016) 22:590–8. 10.1089/tmj.2015.0191
    1. Antonini A, Gentile G, Giglio M, Marcante A, Gage H, Touray MM, et al. . Acceptability to patients, carers and clinicians of an mHealth platform for the management of Parkinson's disease (PD_Manager): study protocol for a pilot randomised controlled trial. Trials. (2018) 19:1–11. 10.1186/s13063-018-2767-4
    1. Ferreira JJ, Godinho C, Santos AT, Domingos J, Abreu D, Lobo R, et al. . Quantitative home-based assessment of Parkinson's symptoms: the SENSE-PARK feasibility and usability study. BMC Neurol. (2015) 15:1–7. 10.1186/s12883-015-0343-z
    1. Cubo E, Mariscal N, Solano B, Becerra V, Armesto D, Calvo S, et al. . Prospective study on cost-effectiveness of home-based motor assessment in Parkinson's disease. J Telemed Telecare. (2017) 23:328–338. 10.1177/1357633X16638971
    1. Santos Mendes FAD, Pompeu JE, Lobo AM, Silva KGD, Oliveira TDP, Zomignani AP, et al. . Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease-effect of motor and cognitive demands of games: a longitudinal, controlled clinical study. Physiotherapy. (2012) 98:217–23. 10.1016/j.physio.2012.06.001
    1. Arroyo-Gallego T, Ledesma-Carbayo MJ, Sánchez-Ferro A, Butterworth I, Mendoza CS, Matarazzo M, et al. . Detection of motor impairment in Parkinson's disease via mobile touchscreen typing. IEEE Trans Biomed Eng. (2017) 64:1994–2002. 10.1109/TBME.2017.2664802
    1. Ferraris C, Nerino R, Chimienti A, Pettiti G, Cau N, Cimolin V, et al. . Feasibility of home-based automated assessment of postural instability and lower limb impairments in Parkinson's disease. Sensors. (2019) 19:1129. 10.3390/s19051129
    1. Lee NY, Lee DK, Song HS. Effect of virtual reality dance exercise on the balance, activities of daily living, and depressive disorder status of Parkinson's disease patients. J Phys Ther Sci. (2015) 27:145–147. 10.1589/jpts.27.145
    1. Yang WC, Wang HK, Wu RM, Lo CS, Lin KH. Home-based virtual reality balance training and conventional balance training in Parkinson's disease: a randomized controlled trial. J Formosan Med Assoc. (2016) 115:734–43. 10.1016/j.jfma.2015.07.012
    1. Song J, Paul SS, Caetano MJD, Smith S, Dibble LE, Love R, et al. . Home-based step training using videogame technology in people with Parkinson's disease: a single-blinded randomised controlled trial. Clin Rehabil. (2018) 32:299–311. 10.1177/0269215517721593
    1. Fung A, Lai EC, Lee. A new smart balance rehabilitation system technology platform: development and preliminary assessment of the Smarter Balance System for home-based balance rehabilitation for individuals with Parkinson's disease. In: 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). Honolulu: IEEE; (2018). p. 1534–7. 10.1109/EMBC.2018.8512528
    1. Allen NE, Song J, Paul SS, Smith S, O'Duffy J, Schmidt M, et al. . An interactive videogame for arm and hand exercise in people with Parkinson's disease: a randomized controlled trial. Parkinsonism Relat Disord. (2017) 41:66–72. 10.1016/j.parkreldis.2017.05.011
    1. Cherney LR, Halper AS, Kaye RC. Computer-based script training for aphasia: emerging themes from post-treatment interviews. J Commun Disord. (2011) 44:493–501. 10.1016/j.jcomdis.2011.04.002
    1. Brennan DM, Georgeadis AC, Baron CR, Barker LM. The effect of videoconference-based telerehabilitation on story retelling performance by brain-injured subjects and its implications for remote speech-language therapy. Telemed J e-Health. (2004) 10:147–54. 10.1089/tmj.2004.10.147
    1. Ward E, Crombie J, Trickey M, Hill A, Theodoros D, Russell T. Assessment of communication and swallowing post-laryngectomy: a telerehabilitation trial. J Telemed Telecare. (2009) 15:232–7. 10.1258/jtt.2009.081204
    1. Sharma S, Ward EC, Burns C, Theodoros D, Russell T. Assessing swallowing disorders online: a pilot telerehabilitation study. Telemed e-Health. (2011) 17:688–95. 10.1089/tmj.2011.0034
    1. Sharma S, Ward EC, Burns C, Theodoros D, Russell T. Training the allied health assistant for the telerehabilitation assessment of dysphagia. J Telemed Telecare. (2012) 18:287–91. 10.1258/jtt.2012.111202
    1. Theodoros D, Aldridge D, Hill AJ, Russell T. Technology-enabled management of communication and swallowing disorders in Parkinson's disease: a systematic scoping review. Int J Lang Commun Disord. (2019) 54:170–88. 10.1111/1460-6984.12400
    1. Venkataraman V, Donohue SJ, Biglan KM, Wicks P, Dorsey ER. Virtual visits for Parkinson disease: A case series. Neurol Clin Pract. (2014) 4:146–52. 10.1212/01.CPJ.0000437937.63347.5a

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