Special Interest Report
Population: Adult
Kathryn Hendron, PT, DPT, NCS, Clinical Research Physical Therapist, Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent, Boston University khendron@bu.edu
Terry Ellis, PhD, PT, NCS, Director of the Center for Neurorehabilitation / Assistant Professor, Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent, Boston University tellis@bu.edu
Nancy Latham, PhD, PT, Research Assistant Professor, School of Public Health, Health and Disability Research Institute, Boston University nlatham@bu.edu
Tamara DeAngelis, PT, DPT, GCS, Senior Physical Therapist, Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent, Boston University trork@bu.edu
Keywords: Prevention, Participation
Purpose:
Although physical therapists (PT) recognize the importance of secondary prevention, effective service delivery models are lacking. Innovative approaches are needed to address this gap. Typically, PT’s see patients with chronic conditions during a discreet episode of care when they have overt disability. Regular monitoring and follow-up is lacking. Supplementing in-person physical therapy visits with remote monitoring using mobile health technology (‘mhealth’) between episodes of care may increase connectivity between PT’s and patients with the goal of preventing or slowing functional decline over the course of the disease. This approach could facilitate sustained engagement in exercise and elevated levels of physical activity in persons with chronic conditions, such as Parkinson disease (PD), with the goal of improving participation in life situations.
Description:
The mhealth intervention is an exercise application (‘Wellpepper’) that can be used in clinical practice for remote monitoring of exercise engagement as well as remote adaptation and progression of exercise programs. The exercise application is housed on a tablet or smartphone. During in-person visits, patients are videotaped performing their prescribed exercises. These videos are stored in the “cloud” allowing the PT to add or remove exercises over time. Data from an activity tracker, integrated into the exercise application, provides patients real-time feedback with the goal of promoting increased physical activity levels. At home, patients can access their exercise program on the tablet or smartphone and indicate level of difficulty and/or presence of pain. The exercise application also allows remote communication between the patient and PT via a two-way text chat. This allows the PT to monitor adherence and remotely change the video-based exercises facilitating progression of the program.
Summary of Use:
An innovative model of physical therapy using mhealth technology was implemented in twenty-four patients with mild to moderate PD. Patients with PD participated in initial in-person clinic sessions with a PT to establish a home exercise and walking program using an activity tracker. Patients exercised at home using the tablet and exercise application. Adherence to the exercise application was 72% over the course of the 6-month intervention. In these 24 subjects, a significant increase in physical activity was revealed from baseline to 6 months using the Godin Leisure Time Total score (p < 0.001).
Importance to Members:
This report highlights an innovative approach using mobile health technology allowing the PT to remotely monitor and adapt exercise programs between episodes of care for those with chronic neurological conditions. This approach enhances the continuity of care contributing to long-term engagement in exercise with the goal of optimizing participation in life situations.
Citation:
Hendron, Kathryn , PT, DPT, NCS; Ellis, Terry , PhD, PT, NCS; Latham, Nancy , PhD, PT; DeAngelis, Tamara , PT, DPT, GCS. Mobile health technology to promote physical activity in persons with Parkinson disease.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/103_hendron-et-al/