TY - JOUR
T1 - Use of a Telehealth System to Enhance a Home Exercise Program for a Person with Parkinson Disease
T2 - A Case Report
AU - Chatto, Charlotte A.
AU - York, Paul T.
AU - Slade, Catherine P.
AU - Hasson, Scott M.
N1 - Publisher Copyright:
Copyright © 2018 Academy of Neurologic Physical Therapy, APTA.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background and Purpose: This case addresses feasibility of a home-based telehealth system to enhance home exercise program (HEP) adherence for a patient with Parkinson disease (PD). We describe START - System for Technology-Augmented Rehabilitation and Training - and discuss outcomes after integrating START into the HEP component of an established therapy protocol, Lee Silverman Voice Technique BIG (LSVT BIG). Case Description: The participant was a 67-year-old woman with PD at Hoehn and Yahr Stage II. Intervention: During the first 4 weeks of a 4-month intervention, a physical therapist guided the participant through the LSVT BIG protocol. START was introduced at week 3; the participant was encouraged to complement her daily HEP through the end of the fourth month with START. Outcomes: Improvements in gait, endurance, balance confidence, and quality of life were observed from the start of the assessment to the end of month 1. By month 4, the participant maintained or improved with respect to these outcomes. Monitored by START, the rate of adherence to her twice-daily HEP prescription was 24%, but her daily participation rate was 78%. The participant's satisfaction with the START system was high, although autonomous feedback provided by START was a limiting concern. There were no technical issues or adverse events reported. Discussion: This case supports START as a feasible HEP telehealth solution for physical therapy, given that increased long-term exercise adherence may improve health outcomes for people with PD. The outcomes of this case study support further investigation into the use of START for people with PD. Video Abstract available for more insights from the authors (see Video; Supplemental Digital Content 1, http://links.lww.com/JNPT/A192).
AB - Background and Purpose: This case addresses feasibility of a home-based telehealth system to enhance home exercise program (HEP) adherence for a patient with Parkinson disease (PD). We describe START - System for Technology-Augmented Rehabilitation and Training - and discuss outcomes after integrating START into the HEP component of an established therapy protocol, Lee Silverman Voice Technique BIG (LSVT BIG). Case Description: The participant was a 67-year-old woman with PD at Hoehn and Yahr Stage II. Intervention: During the first 4 weeks of a 4-month intervention, a physical therapist guided the participant through the LSVT BIG protocol. START was introduced at week 3; the participant was encouraged to complement her daily HEP through the end of the fourth month with START. Outcomes: Improvements in gait, endurance, balance confidence, and quality of life were observed from the start of the assessment to the end of month 1. By month 4, the participant maintained or improved with respect to these outcomes. Monitored by START, the rate of adherence to her twice-daily HEP prescription was 24%, but her daily participation rate was 78%. The participant's satisfaction with the START system was high, although autonomous feedback provided by START was a limiting concern. There were no technical issues or adverse events reported. Discussion: This case supports START as a feasible HEP telehealth solution for physical therapy, given that increased long-term exercise adherence may improve health outcomes for people with PD. The outcomes of this case study support further investigation into the use of START for people with PD. Video Abstract available for more insights from the authors (see Video; Supplemental Digital Content 1, http://links.lww.com/JNPT/A192).
KW - adherence
KW - compliance
KW - home exercise program
KW - motion capture
KW - telerehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85037737284&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85037737284&partnerID=8YFLogxK
U2 - 10.1097/NPT.0000000000000209
DO - 10.1097/NPT.0000000000000209
M3 - Article
C2 - 29206708
AN - SCOPUS:85037737284
SN - 1557-0576
VL - 42
SP - 22
EP - 29
JO - Journal of Neurologic Physical Therapy
JF - Journal of Neurologic Physical Therapy
IS - 1
ER -