Adopting a multidisciplinary telemedicine intervention for fall prevention in Parkinson’s disease. Protocol for a longitudinal, randomized clinical trial

Abstract

Background Approximately 40–70% of people with Parkinson’s disease (PD) fall each year, causing decreased activity levels and quality of life. Current fall-prevention strategies include the use of pharmacological and non-pharmacological therapies. To increase the accessibility of this vulnerable population, we developed a multidisciplinary telemedicine program using an Information and Communication Technology (ICT) platform. We hypothesized that the risk for falling in PD would decrease among participants receiving a multidisciplinary telemedicine intervention program added to standard office-based neurological care. Objective To determine the feasibility and cost-effectiveness of a multidisciplinary telemedicine intervention to decrease the incidence of falls in patients with PD. Methods Ongoing, longitudinal, randomized, single-blinded, case-control, clinical trial. We will include 76 non-demented patients with idiopathic PD with a high risk of falling and limited access to multidisciplinary care. The intervention group (n = 38) will receive multidisciplinary remote care in addition to standard medical care, and the control group (n = 38) standard medical care only. Nutrition, sarcopenia and frailty status, motor, non-motor symptoms, health-related quality of life, caregiver burden, falls, balance and gait disturbances, direct and non-medical costs will be assessed using validated rating scales. Results This study will provide a cost-effectiveness assessment of multidisciplinary telemedicine intervention for fall reduction in PD, in addition to standard neurological medical care. Conclusion In this challenging initiative, we will determine whether a multidisciplinary telemedicine intervention program can reduce falls, as an alternative intervention option for PD patients with restricted access to multidisciplinary care. Trial registration ClinicalTrials.gov Identifier: NCT04694443.

Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease

“…Although many physical therapy interventions for PwP are amenable to telehealth, development of an individualized multi-modal intervention plan requires a comprehensive examination battery to facilitate clinical decision making, design the plan of care, and evaluate patient progress ( Flynn et al, 2023 ; Osborne et al, 2022 ; Quinn et al, 2020 ; Shih et al, 2022 ; van der Kolk et al, 2019 ). One of the primary concerns in telehealth is safety of administering tests and measures when a therapist is not in person to provide guarding and environmental cueing ( Bennell et al, 2021 ; Bianchini et al, 2022 ; Colón-Semenza et al, 2023 ; Cubo et al, 2021 ; Thwaites et al, 2023 ). While there are a few outcomes that do not lend themselves well to telehealth administration (i.e., compensatory stepping, 6MWT), many movement-based assessments can readily be adapted to telehealth administration.…”

Telemedicine as a measure to prevent falls in older people in their homes: literature review

“…La telemedicina nace de la unión de la tecnología y la medicina para la utilización en los procesos sanitarios y ponerla al servicio de la persona para mejorar y/o mantener su salud. La Organización Mundial de la Salud (OMS) define la telemedicina como «aportar servicios de salud por cualquier profesional de la salud, usando las nuevas tecnologías de la comunicación para el intercambio de información en el diagnóstico, el tratamiento y la prevención de enfermedades o lesiones, investigación y evaluación, y educación continuada de los proveedores de salud, todo con el interés de mejorar la salud del individuo y sus comunidades» 34,35 .…”

A Holter for Parkinson's Disease Motor Symptoms: STAT-ONTM

“…Integration of the telemedicine in the management of PD could be useful to remotely monitor the PD motor complications, facilitate the access to care, complement, or replace the in-office consultations specially when these are not possible for geographical reasons, improving the detection of patients who are candidates to a device-aided therapy and facilitate the monitoring of device-aided therapies [57][58][59]. Moreover, the STAT-ON™ can be used as a part of a multidisciplinary telemedicine intervention with the aim of reducing the risk of some complications such as falls [60]. Even the information of the STAT-ON™ can be complementary to the other devices [61] and all together useful for making decisions about the treatment of the patient with PD.…”