Abstract
Background: People with PD experience decreased balance ability and gait speed, but on-site training which has been proven effective is not feasible to patients with transportation barriers. Home-based telethealth has grown rapidly since the COVID-19 pandemic and has shown effectiveness in improving gait and balance in this population, but most interventions required expensive equipment or prolonged training periods, therefore our study aimed to explore the effects of a short-term exercise program delivered through simple digital devices and determine if such treatment could produce similar results to a short-term hospital based exercise program.
Approach: We recruited 13 patients (63.4±8.1 years old) to a five-week telehealth program which was addressed through networking apps. Participants were first given video links to the exercises which consisted of 25 minutes of dynamic movement training and 25 minutes of core muscle training. During the study period, participants interacted with a physical therapist through networking apps as scheduled, who would adjust the exercise intensity by giving feedback and by sending new video links leading to the exercise as appropriate. For the hospital based training, 13 age-mated patients (64.7.5±5.2 years old) were recruited to receive 25 minutes of dynamic movement training and 25 minutes of core muscle training led by two physical therapists twice a week in the hospital. Balance and gait were assessed in both groups before and after intervention by applying the Mini Balance Evaluation Systems Test (Mini-BESTest) and the 10-Meter Walk Test (10MWT). Statistical difference between groups pre- and post-training was determined using a two way repeated measures ANOVA, with a significance level set at p<0.05.
Results: Both balance and gait parameters improved in both groups, but the telehealth group only showed significant differences in balance (Mdiff=3.31±2.96, p=0.002), while the hospital group showed significant differences in balance (Mdiff=3.54±3.33, p=0.002) and in gait parameters (Mdiff=0.14±0.21, p=0.033) before and after training. However, there was no significant differences on the Mini-BESTest total score and 10MWT between the two groups.
Implications: The results indicate that both short-term exercise programs delivered through telehealth or in the hospital significantly improved the balance ability of PD patients. Although significant improvements in gait speed was observed in the hospital training group, the gait speed of the telehealth group also improved. These findings suggest that a remote short-term exercise program can be delivered at home and bring forth results similar to on-site training regarding balance and gait speed, and can serve as an option in future healthcare treatment in PD patients.