Digital Intervention Promoting Physical Activity in People Newly Diagnosed with Parkinson's Disease: Feasibility and Acceptability of the Knowledge, Exercise-Efficacy and Participation (KEEP) Intervention.

Background: Exercise promotion interventions for people with Parkinson's disease (PD) are often offered on a face-to-face basis, follow a generic "one-size-fit-all" approach, and are not typically delivered at diagnosis. Considering PD's heterogenous nature, the existing evidence on the merits of exercise on symptom management and the expressed wishes of people living with PD for access to timely and tailored evidence-based information, there is a demand for interventions that are easily accessible, scalable and co-designed with people living with PD. Objective: Evaluate the feasibility and acceptability of a co-designed digital intervention promoting exercise and physical activity, in people newly diagnosed with PD. Methods: Thirty people living with PD for less than one year participated in an assessor-blinded randomized feasibility trial from June 2022 to April 2023. The intervention group received the 8-week Knowledge, Exercise Efficacy and Participation (KEEP) intervention comprising 6 interactive digital modules and 4 online live group discussions facilitated by a specialist physiotherapist. Assessments were performed at baseline, post intervention and at 6-month follow up. Results: Thirty participants were recruited to target with a 64% recruitment rate (30/47). All but one participant completed the 6-month follow-up assessment. There was high retention (97%), module completion (91%), and online discussion attendance (88%). Outcome measure collection was feasible, including accelerometer data with a daily average wear time of 23.9 hours (SD:0.295). Conclusions: The KEEP intervention was feasible and acceptable in people newly diagnosed with PD. A larger trial is needed to assess intervention efficacy and correlation between knowledge, self-efficacy, and activity levels.

Exercise and physical activity have been found beneficial in managing both motor and non-motor symptoms in people living with Parkinson's. But there aren't many programs available right after diagnosis that focus on exercise and explain why it's important for managing PD symptoms and how to exercise with PD. Most existing programs use a one-size-fit-all approach and don't give personalized information. In this study, researchers wanted to see if people who were recently diagnosed with PD would join a study promoting exercise through an online program. This program included educational information and live online group discussions with both people living with Parkinson's and a specialist physiotherapist. The program was developed together with people living with Parkinson's and healthcare professionals to ensure that it better suited the needs of people newly diagnosed with PD. Thirty people took part in the study. They were randomly put into two groups: one received the online program, while the other group continued with their usual care. Participants filled out questionnaires and wore a wrist accelerometer for seven days to track their physical activity levels. The researchers found that most participants stayed in the study (97%), completed the program modules (91%), and attended the live discussions (88%) and wore the accelerometers for 23.9 hours a day on average. Overall, the study showed that the program was doable and well-received. Participants said they had a better understanding on the benefits of exercise in PD. However, a larger study is needed to see if the program helps increase activity levels.

Exploring the experiences, priorities and preferences of people living with Parkinson's on exercise and physical activity promotion in the UK.

BACKGROUND: People with Parkinson's (PwP) want access to timely, relevant, and specific exercise and physical activity (PA) information to enable them to manage their symptoms and maintain wellbeing and quality of life. Research that promotes exercise in this population group is limited. Little is also known about the clinical practice around PA promotion in this population, especially around the time of diagnosis. OBJECTIVE: To explore the experiences, preferences, and priorities of PwP around exercise and PA promotion and assess their knowledge on these topics. METHODS: A cross-sectional online survey for PwP in the United Kingdom was conducted from July to December 2021. RESULTS: 430 participants started the survey and 405 completed it. Participants had a mean age of 65.1 (±9.2) and had been living with Parkinson's for a varying time (up to 2 years = 38%, up to 6 years = 39% and for 7 or more years = 23%). Most participants reported they had not received an education (68%; n = 276) or exercise intervention (54%; n = 217) as part of their routine management by the National Health Service (NHS) since diagnosis and had sought services privately. Knowledge of the overall benefits of exercise was good, however participants lacked specific knowledge on the impact of Parkinson's Disease (PD) on posture, falls and muscle strength. 90% of participants reported they would participate in an exercise and PA education interventions. CONCLUSIONS: PwP want exercise and PA education interventions that provide knowledge, skills and access to opportunities that enable participation. For the majority, these interventions have not been provided as part of their routine care pathway. To align with the priorities and preferences of PwP, interventions should be offered around the time of diagnosis, include content that is relevant and specific to how exercise and PA can mitigate symptoms of PD and should be delivered in person or online in a group setting.

Exercise and physical activity promotion for people newly diagnosed with Parkinson's disease: a UK survey exploring current practice and the views of healthcare professionals.

OBJECTIVES: Exercise and physical activity (PA) are increasingly recognized as important components in the management of Parkinson's disease (PD). Their promotion at diagnosis is essential for better management of symptoms and overall well-being. Healthcare professionals (HCPs) are pivotal to the promotion of exercise and PA, but there is limited guidance on the content of such interventions. This study describes current practice, and explores views of HCPs around PA and exercise promotion at diagnosis for people with PD (PwP) DESIGN: A cross-sectional study using an anonymous online survey. PARTICIPANTS: HCPs working with PwP in the UK. RESULTS: Twenty-nine doctors, 17 nurses and 106 physiotherapists completed the survey. All nurses, 99% of physiotherapists and 72% of doctors reported that they always promote exercise and PA during clinic appointments. HCPs identified how PA impacts PD symptoms, evidence on the role of exercise, and signposting to support groups as core topics in PA promotion for PwP. However, these topics are mainly addressed during physiotherapy appointments. Referrals to physiotherapy occur most frequently when PwP experience falls or mobility issues, rather than at diagnosis. HCPs (52% doctors and 41% of nurses) identified lack of confidence as a barrier to prescribing exercise to PwP. CONCLUSION: The importance of promoting PA at diagnosis is widely acknowledged by HCPs. There are variations between disciplines in terms of the tools used, and the timing and duration of interventions. Previously identified barriers to exercise promotion were also found in this study, and should be explored further in order to aid the implementation of effective interventions.