Background People with Parkinson's disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants' perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson's disease. Methods Twenty adults with Parkinson's disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach's supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. Results Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. Conclusion Findings demonstrate that adults with Parkinson's disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.

BackgroundSpinal cord injury (SCI) results in significant loss of function below the level of injury, often leading to restricted participation in community exercise programs. To overcome commonly experienced barriers to these programs, innovations in technology hold promise for remotely delivering safe and effective bouts of exercise in the home.ObjectiveTo test the feasibility of a remotely delivered home exercise program for individuals with SCI as determined by (1) implementation of the intervention in the home; (2) exploration of the potential intervention effects on aerobic fitness, physical activity behavior, and subjective well-being; and (3) acceptability of the program through participant self-report.MethodsFour adults with SCI (mean age 43.5 [SD 5.3] years; 3 males, 1 female; postinjury 25.8 [SD 4.3] years) completed a mixed-methods sequential design with two phases: an 8-week intervention followed by a 3-week nonintervention period. The intervention was a remotely delivered aerobic exercise training program (30-45 minutes, 3 times per week). Instrumentation included an upper body ergometer, tablet, physiological monitor, and custom application that delivered video feed to a remote trainer and monitored and recorded exercise data in real time. Implementation outcomes included adherence, rescheduled sessions, minutes of moderate exercise, and successful recording of exercise data. Pre/post-outcomes included aerobic capacity (VO2 peak), the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), the Satisfaction with Life Scale (SWLS), and the Quality of Life Index modified for spinal cord injury (QLI-SCI). Acceptability was determined by participant perceptions of the program features and impact, assessed via qualitative interview at the end of the nonintervention phase.ResultsParticipants completed all 24 intervention sessions with 100% adherence. Out of 96 scheduled training sessions for the four participants, only 8 (8%) were makeup sessions. The teleexercise system successfully recorded 85% of all exercise data. The exercise program was well tolerated by all participants. All participants described positive outcomes as a result of the intervention and stated that teleexercise circumvented commonly reported barriers to exercise participation. There were no reported adverse events and no dropouts.ConclusionA teleexercise system can be a safe and feasible option to deliver home-based exercise for persons with SCI. Participants responded favorably to the intervention and valued teleexercise for its ability to overcome common barriers to exercise. Study results are promising but warrant further investigation in a larger sample.

PURPOSE. We explored the occupational performance and home safety perspectives of older adults with vision loss. Our study focused on the person–environment interaction to ascertain whether participants’ concerns are addressed by three commonly used home safety assessments. METHOD. Twenty-two older adults with vision loss participated in face-to-face interviews regarding their perspectives on home safety. We compared categories generated from a content analysis of the data with the contents of three standardized home safety assessments. RESULTS. Five categories of home safety emerged from the analysis: (1) lighting, (2) contrast, (3) visual distractions, (4) glare, and (5) compensation strategies. Comparisons of content in the three home safety assessments with emerged categories revealed that study participants had specific concerns about home safety that were not thoroughly addressed in the selected assessments. CONCLUSION. The findings provide preliminary content areas that should be included in the development of a home assessment specific to the low vision population.

Introduction: Occupational therapy practitioners who provide interventions for adults with low vision need to understand challenges with occupational performance from the individual's perspective in order to implement effective treatment. The purpose of this study was to understand self-described occupational behaviors of persons with low vision. Method: This qualitative study included semi-structured interviews regarding the occupational experiences of 22 individuals with varying levels of vision impairment. Transcribed data were organized according to the areas of occupation reported in the American Occupational Therapy Association's Practice Framework. Results: Participants described occupational performance of activities of daily living, instrumental activities of daily living, and leisure. Within each area of occupation, participants reported lighting, contrast, familiarity, and organization within the environment as facilitators or barriers to participation. Participants with increased vision loss relied heavily on assistive devices, task simplification, and others to perform desired occupations. Conclusion: The information obtained in this study can assist practitioners in selecting more effective interventions to increase the independence and safety of individuals with low vision.

Both vision loss and comorbidities influence occupational performance, supporting the need for interventions to address both conditions.