The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson's disease: a long-term feasibility study.
| Title: | The effects of an individualized smartphone-based exercise program on self-defined motor tasks in Parkinson's disease: a long-term feasibility study. |
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| Authors: | Lützow L; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Teckenburg I; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Koch V; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany.; Marxreiter F; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Center for Movement Disorders, Passauer Wolf, Bad Gögging, Neustadt an der Donau, Germany.; Jukic J; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Stallforth S; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Medical Valley - Digital Health Application Center GmbH, Bamberg, Germany.; Regensburger M; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Winkler J; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Klucken J; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.; Medical Valley - Digital Health Application Center GmbH, Bamberg, Germany.; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany.; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg.; Luxembourg Institute of Health, Strassen, Luxembourg.; Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg.; Gaßner H; Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany. heiko.gassner@uk-erlangen.de.; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany. heiko.gassner@uk-erlangen.de. |
| Source: | Journal of patient-reported outcomes [J Patient Rep Outcomes] 2023 Oct 30; Vol. 7 (1), pp. 106. Date of Electronic Publication: 2023 Oct 30. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Springer International Publishing Country of Publication: Germany NLM ID: 101722688 Publication Model: Electronic Cited Medium: Internet ISSN: 2509-8020 (Electronic) Linking ISSN: 25098020 NLM ISO Abbreviation: J Patient Rep Outcomes Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Heidelberg] : Springer International Publishing, [2017]- |
| MeSH Terms: | Parkinson Disease*/therapy; Exercise Therapy/methods ; Humans ; Quality of Life ; Smartphone ; Feasibility Studies ; Pandemics ; Treatment Outcome ; Exercise |
| Abstract: | Background: Exercise therapy is considered effective for the treatment of motor impairment in patients with Parkinson's disease (PD). During the COVID-19 pandemic, training sessions were cancelled and the implementation of telerehabilitation concepts became a promising solution. The aim of this controlled interventional feasibility study was to evaluate the long-term acceptance and to explore initial effectiveness of a digital, home-based, high-frequency exercise program for PD patients. Training effects were assessed using patient-reported outcome measures combined with sensor-based and clinical scores.; Methods: 16 PD patients (smartphone group, SG) completed a home-based, individualized training program over 6-8 months using a smartphone app, remotely supervised by a therapist, and tailored to the patient's motor impairments and capacity. A control group (CG, n = 16) received medical treatment without participating in digital exercise training. The usability of the app was validated using System Usability Scale (SUS) and User Version of the Mobile Application Rating Scale (uMARS). Outcome measures included among others Unified Parkinson Disease Rating Scale, part III (UPDRS-III), sensor-based gait parameters derived from standardized gait tests, Parkinson's Disease Questionnaire (PDQ-39), and patient-defined motor activities of daily life (M-ADL).; Results: Exercise frequency of 74.5% demonstrated high adherence in this cohort. The application obtained 84% in SUS and more than 3.5/5 points in each subcategory of uMARS, indicating excellent usability. The individually assessed additional benefit showed at least 6 out of 10 points (Mean = 8.2 ± 1.3). From a clinical perspective, patient-defined M-ADL improved for 10 out of 16 patients by 15.5% after the training period. The results of the UPDRS-III remained stable in the SG while worsening in the CG by 3.1 points (24%). The PDQ-39 score worsened over 6-8 months by 83% (SG) and 59% (CG) but the subsection mobility showed a smaller decline in the SG (3%) compared to the CG (77%) without reaching significance level for all outcomes. Sensor-based gait parameters remained constant in both groups.; Conclusions: Long-term training over 6-8 months with the app is considered feasible and acceptable, representing a cost-effective, individualized approach to complement dopaminergic treatment. This study indicates that personalized, digital, high-frequency training leads to benefits in motor sections of ADL and Quality of Life.; (© 2023. The Author(s).) |
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| Grant Information: | 820820 European Union's Horizon 2020 research and innovation program; 820820 European Federation of Pharmaceutical Industries and Associations; SFB 1483-Project-ID 442419336 Deutsche Forschungsgemeinschaft; 438496663 Mobility APP; 044-602140 Fraunhofer Internal Programs; 044-602150 Fraunhofer Internal Programs |
| Entry Date(s): | Date Created: 20231030 Date Completed: 20231101 Latest Revision: 20250519 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10616049 |
| DOI: | 10.1186/s41687-023-00631-6 |
| PMID: | 37902922 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't