Design of the WHIP-PD study: a phase II, twelve-month, dual-site, randomized controlled trial evaluating the effects of a cognitive-behavioral approach for promoting enhanced walking activity using mobile health technology in people with Parkinson-disease

Abstract

Background: Parkinson disease (PD) is a debilitating and chronic neurodegenerative disease resulting in ambulation difficulties. Natural walking activity often declines early in disease progression despite the relative stability of motor impairments. In this study, we propose a paradigm shift with a "connected behavioral approach" that targets real-world walking using cognitive-behavioral training and mobile health (mHealth) technology.

New Strategies to Improve the Quality of Life for Normal Aging versus Pathological Aging

“…In order to investigate motor abilities and gait performance, the following scales were used: SPPB, and TUG, which investigated motors ability beginning for 3 m walking then turn and back walk and stand of chair [ 4 , 10 , 13 , 15 , 18 , 22 , 25 , 31 , 35 ]. For assessing parameters of gait used instruments, such as 5TSTST, 6 min walk test, 4,10,400 m WT, SEW-D, DGI, TLS, MDRT, MSL, and scales that investigate walking at the highest speeds, track the length and frequency of the step and their completion times [ 10 , 15 , 19 , 25 , 31 , 33 , 36 , 37 ]. Quantifying balance and posture both statically and dynamically is extremely important in assessing the motor and functional status of the healthy elderly adult, but also of the older adults with neurodegenerative impairments.…”

“…The most appreciated tools in this regard are BBS, scale with score range from 0–56, which assess balance tasks [ 14 , 20 , 33 , 38 ]. The scale BOOMER measures outcomes in elderly rehabilitation [ 10 ], ABC, BARSE, SEE, SIBT, COP, and One foot balance test, give confidence in balancing activities [ 19 , 22 , 33 , 37 , 39 ] and other tools, such as PASE, Grip strength, Back scratch, and ROM, appreciate the varying degrees of physical activity performed by older adults [ 14 , 19 , 22 , 25 , 31 ]. Training dual task was appreciated through DT-FPT, SOT, MDC, and FRT [ 22 , 33 , 40 ].…”

“…Telerehabilitation was conducted using the following tools: a tablet which had items for cognitive activities, including language, memory, attention, visual and spatial skills, executive functions and other instruments; a sphygmomanometer for the detection blood pression, pulse oximeter which measures saturation oxygen, heart rate, scale for body weight; and a Fit Bit which quantified load physical and sleep activity. Through the ability program developed on the tablet app, beneficial effects were highlighted for mental and physical activity at older adults with cognitive impairments [ 37 ]. Through RedCap software app., promoted an educational material regarding shoulder health in ALS, with beneficial results for improving motricity and strength developed in upper limbs, as well as relief of ALS pain in the shoulders.…”

Physical Activity Coaching via Telehealth for People With Parkinson Disease: A Cohort Study

“…The emphasis on therapist-participant interaction and autonomous goal setting is in contrast with other studies that have used mobile health to prescribe and monitor remote exercise programs. [28][29][30][31][32] Coaching is well-suited to be delivered via telehealth, and may decrease the barriers in transportation and time. 26 Using telehealth to deliver the intervention was crucial for recruiting the majority of the participants, which highlights the potential of telehealth to increase the accessibility of care for people with chronic diseases.…”

Natural Walking Intensity in Persons With Parkinson Disease

“…We conducted a cross-sectional, secondary analysis of baseline step count data collected as part of an ongoing prospective, 12-month, single-blind, multisite, randomized controlled trial Walking and mHealth to Increase Participation in Parkinson Disease (WHIP-PD: Clinical Trials Registration NCT03517371). 32 The WHIP-PD trial complies with the standards of the Declaration of Helsinki and was approved by the Institutional Review Board at Boston University. The trial includes adults meeting the following criteria: a diagnosis of idiopathic, typical PD according to the United Kingdom Brain Bank Criteria; mild to moderate disease severity (Modified Hoehn and Yahr stages 1-3); community-dwelling; ability to walk 10 continuous minutes without help from another person; and stable on all PD medications for at least 2 weeks prior to study entry.…”