Reforming Home-Based Care: Can Phone Apps Boost Mobility in Parkinson’s Patients? Written Lay Summary

Recently, in 2023 a team of scientists led by Martina Putzolu published a study on advantages of smartphone apps that can promote an active lifestyle for people diagnosed with Parkinson’s Disease. Parkinson’s Disease (PD) is a neurological disorder that has been reported to worsen over the course of time. The main symptoms of PD include tremors, muscle stiffness, issues with posture and walking. However, the issues are not limited to movement, but they also affect the person’s mental processes such as memory and problem-solving and can also result in depression and anxiety. Additionally, Parkinson’s disease makes it hard to move and stay active, which can worsen these symptoms. Physical activity and physiotherapy, along with the medicines, are believed to help the patients gain more independence in their daily activities and improve their physical and mental symptoms. Unfortunately, these benefits do not last long if these programs are not followed regularly. Over time, many barriers have been identified that discourage these people from exercising regularly, including; lack of time, money, transportation and social support. Therefore, there is a need for novel solutions that have the ability to promote long term commitment to exercise and support for an overall active lifestyle. One such solution happens to be a smartphone app named Parkinson Rehab, that allows customisable, minimally supervised home-based exercise plans.

To understand and test the effectiveness of this program, Ministry of Health and Ministry of university and Research funded a team of researchers from various institutes in Italy. The team of researchers conducted a feasibility study on benefits of using apps such as “Parkinson Rehab”, used by participants in this study. A feasibility study is an initial check to see if a project is practical, affordable, and likely to succeed before spending a lot of resources. In this study, the researchers looked at whether a 2-month home exercise program was doable, easy to use, safe, and helpful. They also checked how it affected the severity of Parkinson’s disease, movement, mental skills, and mood. The study involved 20 people who had been diagnosed with idiopathic Parkinson’s disease, meaning they had typical Parkinson’s without any other serious health problems. These participants were in the early to middle stages of the disease, could walk on their own, and took their medications regularly. People with other neurological conditions, severe memory or thinking problems, orthopaedic issues, or vision and hearing problems that could interfere with using the app were not included. This was to ensure that all participants could safely complete the exercise program using the app.

What the researchers did

Using the Parkinson Rehab app, participants did a fitness program at home that lasted 8 weeks. The app had three main parts: first, a profile section where they entered personal and health information; second, a training part with 42 videos that showed exercises to help with Parkinson’s symptoms like posture, stiffness, balance, coordination, and walking; third, a step tracker that recorded daily activity levels and steps taken. Each person started with a plan tailored to their current abilities. Every two weeks, a physiotherapist checked on their progress and adjusted the exercises to make them more challenging. Participants were encouraged to exercise every day, either once or twice, for about 30 to 40 minutes each time. The exercises gradually became harder and more complex as the program went on. To keep participants motivated, physiotherapists made occasional phone calls to encourage them, answer questions, and help change exercises if needed. Participants also kept daily diaries of their exercises, which the healthcare team reviewed.

What they found

The main goals of the study were to see if the patients could stick to the program? Will they like it or consider it useful? Will it be safe? Fortunately, results revealed favourable findings. On average, individuals attended around 91% of the recommended sessions, suggesting strong commitment. In addition to this, participants rightfully completed their daily activity diaries 94% of the time, showing that they were driven and motivated. Only two participants dropped abruptly for reasons that were not related to the training course, bringing the dropout rate to around 10% only, which is lower than in previous research on similar study design. Lastly, there were no injuries or falls reported during the exercises, showing that the exercises were safe for the participants in this group. The majority of users gave the program a positive review, stating that the activities were safe, entertaining, and appropriate for their skills. Satisfaction surveys scored high, indicating that consumers valued the app’s usefulness and found it inspiring. Furthermore, this training also resulted in better thinking and memory skills than the beginning of study and lasted at least a month after completion. However, the study found no significant differences in mood or anxiety levels. This shows that exercise can enhance physical and cognitive capacities. Perhaps, mood benefits may need longer or more complex therapies; therefore, more research is needed on this topic.

What next

While the results are exciting, the researchers underlined the importance of bigger, controlled studies to validate and expand on them. We should be aware of the study’s limitations. First, it only included a small number of people and they did not account for the age of participants, so we can’t be sure the results will be the same for everyone with Parkinson’s disease. Second, the study only lasted two months, so we don’t know if the benefits last a long time. Future studies could look at how these treatments work for people with more advanced Parkinson’s or different types of the disease. Also, longer studies could help us understand if the improvements stay over time and how to make the app more helpful and engaging.

To sum up…

To conclude, this novel research shows that using a smartphone app for home-based training in Parkinson’s disease is possible, safe, and related with noticeable improvements in movement and mental skills. The strong rates of commitment show that with the right design and remote help, patients are motivated to stick to their habits. The use of technology into PD treatment represents a viable path toward more accessible, individualised, and effective therapy. As digital health advances, technologies like this app may become routine elements of comprehensive treatment plan for Parkinson’s disease. I would like to think that having such resources within easy reach will enable patients to take an active part in their health, preserve independence for extended periods of time, and improve their quality of life within the comfort of their own homes.