Virtual Rehab Comparable With In-Person Care for Parkinson’s

TOPLINE:

Rehabilitation delivered via a mobile-based video program — called teleneurorehabilitation — was as safe and effective as in-person rehabilitation in managing motor and nonmotor symptoms in patients with Parkinson’s disease (PD), a new study showed.

METHODOLOGY:

• This single-center, assessor-blinded, randomized clinical trial, conducted from 2020 to 2021, included 63 participants with idiopathic PD with Hoehn and Yahr stages 1-2.5, as well as a Mini Mental State Examination score ≥ 24 and access to a smartphone for video calling.
• Participants were randomly assigned to receive either teleneurorehab (n = 35) or in-person rehab (n = 28) for improving postural control; active and assistive limb mobilization; and flexibility, aerobic, balance, and gait training.
• Both groups followed a 12-week schedule consisting of weekly 30-minute sessions for 4 weeks, followed by biweekly sessions for 8 weeks. The teleneurorehabilitation group received one in-person session, followed by virtual ones, while the other group received all sessions in person.
• The primary outcome was the change from baseline to postintervention in mean Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III scores.
• Also assessed during the same period were mean changes in MDS-UPDRS II, Non-Motor Symptoms Scale (NMSS), Parkinson’s Disease Questionnaire-8 Summary Index (PDQ8-SI), 6-minute walk test (6MWT), and functional reach test (FRT) scores.

TAKEAWAY:

• The adherence rate was 71.4% in the teleneurorehabilitation group, with no significant adverse events, and 82.1% in the in-person group.
• Mean MDS-UPDRS III scores decreased significantly for both groups: From 35.2 to 28.6 in those receiving teleneurorehabilitiation (P = .001) and from 38.1 to 30.6 in those receiving in-person care (P = .001).
• Both groups also showed significant improvements in NMSS, PDQ8-SI, FRT, and 6MWT scores postintervention.
• There were no significant between-group differences in postintervention score changes, indicating comparable effectiveness.

IN PRACTICE:

Teleneurorehabilitiation “is especially beneficial for patients with PD in low-income and middle-income countries where transportation costs and regular hospital visits are limiting factors for providing rehabilitation,” the investigators wrote.

SOURCE:

The study was led by Rajinder K. Dhamija, Institute of Human Behaviour and Allied Sciences, New Delhi, India. It was published online on February 24 in JAMA Neurology.

LIMITATIONS:

Study limitations included its single-center design, its small sample size, that only patients with mild to moderate PD were included, and no assessment of voice rehabilitation protocols. Additionally, the study used limited rehabilitation assessment scales and did not evaluate patient-perceived satisfaction.

DISCLOSURES:

No funding information was provided for the study. The investigators reported having no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.