Adherence rate, barriers to attend, safety and overall experience of a physical exercise program via telemonitoring during COVID-19 pandemic for individuals with Parkinson's disease: A feasibility study.

BACKGROUND: Telemonitoring can maintain daily exercise routine during the COVID-19 pandemic of individuals with Parkinson's disease (PD). However, there are barriers to adherence and attendance with remote physical rehabilitation. The main objective of this study was to evaluate adherence rate, barriers to attendance, and safety of a telemonitoring program for individuals with PD; and secondarily to evaluate the individual and their family members perceived overall experience when performing the telemonitoring physical exercise program. METHODS: This was a phase 1 of a clinical trial, engaging 19 individuals with idiopathic PD of an in-person community rehabilitation program. For 24 weeks an asynchronous telemonitoring physical exercise program delivered two sessions per week by video including warm-up, balance, aerobic and resistance exercises, and cool-down. During the remote program were verified: adherence rate at entrance, attendance rate, barriers to attend, safety, and overall experience of the program. RESULTS AND CONCLUSION: Only one participant did not perform any session and 18 participants completed between 2 and 34 sessions. Participants with a caregiver showed higher attendance rates. The most frequently cited barriers to attend the program were: pain; lack of motor skills; and reduced physical fitness. In relation to safety of the program, the most frequently reported was fear of falling. Although participants reported the telemonitoring program induced health benefits and they had positive experiences for themselves and for their families, most of participants prefer an in-person program. In this sense, the asynchronous telemonitoring physical exercise program was safe, showed moderate adherence, with attendance rate depending on the presence of a companion.

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke.

Introduction: The actions taken by the government to deal with the consequences of the coronavirus diseases 2019 (COVID-19) pandemic caused different levels of restriction on the mobility of the population. The need to continue offering physical exercise to individuals after stroke became an emergency. However, these individuals may have barriers to adhere to the programs delivered remotely. There is a lack of evidence related to adherence, attendance, safety, and satisfaction of remote exercise programs for this population. Objective: The aim was to evaluate adherence and barriers to attend a remote physical exercise program for individuals after stroke. We aimed (a) to identify adherence and attendance rate of the remote physical exercise program (i.e., number of participants engaged, number of sessions attended, and exercise time in remote program); (b) to identify the safety of a remote physical exercise program (i.e., falls, pain, or dizziness when performing the exercises, fear, or insecurity); and (c) to identify the overall experience to participate in a remote program. Materials and methods: This is a longitudinal study, including 36 stroke survivors who already attended a face-to-face physical exercise program prior to the COVID-19 pandemic. The remote physical exercise program included sessions for 2 days/week for a duration of 22 weeks, with a total of 44 sessions, which were delivered asynchrony via recorded video sessions. As outcome measures, we performed two questionnaires (via weekly telephone calls) to identify attendance, barriers, safety, and overall experience related to the program. Results: The adherence rate was 86 (9%). The attendance rate was 19, with a total of 8 sessions (108.3 min/week). The main barriers for lower attendance rate were as follows: lack of motor skills and physical fitness to workout in 80 reports (20.6%), followed by no exercise companion in 44 reports (11.3%). The remote physical program has been shown to be safe, and the overall experience was positive from the perspectives of the participants and the family members. Conclusion: Although the adherence rate was high, the attendance rate was low on the remote physical exercise program. The main barriers to attending the program remotely reflect the need of tailoring individually an asynchrony mode of delivering the sessions to individuals after stroke. Our results also indicate how the COVID-19 impacted the health conditions of stroke survivors. The program was safe, and the overall experience indicated a change in the mental, physical, and social health of individuals after stroke and their family members.