Shih Hai-Jung Steffi, Macpherson Chelsea E, King Miriam, Delaney Elizabeth, Gu Yu, Long Katrina, Reid Jennifer, Fineman Julie, Yu Geraldine, Rieger Jamie, Satchidanand Ashrita, Shah Hiral, Alcalay Roy N, Quinn Lori
Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (H.J.S.S., C.E.M., M.K., Y.G., A.S., L.Q.); Departments of Neurology (E.D., H.S., R.N.A.) and Rehabilitation and Regenerative Medicine (Physical Therapy) (L.Q.), Columbia University Irving Medical Center, New York, New York; Department of Occupational Therapy, San Jose State University, San Jose, California (K.L.); Department of Rehabilitation (Physical Therapy), New York Presbyterian Hospital, New York, New York (J.R., G.Y.); Doctor of Physical Therapy Program, Marist College, Poughkeepsie, New York (J.F.); and Department of Neuroscience, Barnard College of Columbia University, New York, New York (J.R.).
J Neurol Phys Ther. 2022 Oct 1;46(4):240-250. doi: 10.1097/NPT.0000000000000410. Epub 2022 Sep 1.
Physical activity (PA) has many known benefits for people with Parkinson disease (PD); however, many people do not meet recommended levels of frequency or intensity. We designed Engage-PD, a PA coaching program delivered via telehealth and grounded in self-determination theory to promote PA uptake and facilitate exercise self-efficacy in people with Parkinson disease. This study aimed to determine the feasibility and preliminary efficacy of Engage-PD, and to explore whether baseline characteristics were associated with outcomes.
A single cohort of people with PD (n = 62, Hoehn and Yahr I-III) participated in the 3-month Engage-PD program, which consisted of up to 5 telehealth coaching sessions delivered by physical therapists. Feasibility was evaluated based on recruitment and retention rates, along with participants' feedback. Planned and unplanned PA, exercise self-efficacy (ESE), and individualized goals were assessed pre- and post-intervention. Relationships between baseline characteristics and changes in planned PA and ESE were also evaluated.
Recruitment (62%) and retention (85%) rates were high, and the intervention was well accepted and perceived by the participants. From pre- to postintervention, participants increased planned PA (d = 0.33), ESE (d = 1.20), and individualized goal performance (d = 1.63) and satisfaction (d = 1.70). Participants with lower baseline planned PA experienced greater improvements in planned PA, and those with lower baseline ESE experienced greater improvements in ESE.
A telehealth PA coaching program for people with PD was feasible and potentially efficacious. Physical therapist-led coaching may be an important component of a consultative model of care starting early in the disease process.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A393).
体育活动（PA）对帕金森病（PD）患者有诸多益处；然而，许多人的体育活动频率或强度未达到推荐水平。我们设计了Engage-PD项目，这是一个通过远程医疗提供的体育活动指导项目，以自我决定理论为基础，旨在促进帕金森病患者参与体育活动并提高运动自我效能。本研究旨在确定Engage-PD项目的可行性和初步疗效，并探讨基线特征是否与结果相关。
一组帕金森病患者（n = 62， Hoehn和Yahr分级为I-III级）参加了为期3个月的Engage-PD项目，该项目包括由物理治疗师提供的多达5次远程医疗指导课程。基于招募率和留存率以及参与者的反馈对可行性进行评估。在干预前后评估计划内和计划外的体育活动、运动自我效能（ESE）以及个性化目标。还评估了基线特征与计划内体育活动和ESE变化之间的关系。
招募率（62%）和留存率（85%）较高，该干预得到参与者的良好接受和认可。从干预前到干预后，参与者的计划内体育活动（d = 0.33）、ESE（d = 1.20）、个性化目标完成情况（d = 1.63）和满意度（d = 1.70）均有所提高。基线计划内体育活动较低的参与者在计划内体育活动方面改善更大，而基线ESE较低的参与者在ESE方面改善更大。
针对帕金森病患者的远程医疗体育活动指导项目是可行且可能有效的。由物理治疗师主导的指导可能是在疾病进程早期开始的咨询式护理模式的重要组成部分。可观看视频摘要以获取作者更多见解（见视频，补充数字内容1，可在：http://links.lww.com/JNPT/A393获取）。
