Exercise Management Using a Mobile App in Patients With Parkinsonism: Prospective, Open-Label, Single-Arm Pilot Study (Preprint)

Abstract

BACKGROUND Although exercise has benefits for motor function and quality of life in patients with parkinsonism, these patients have many barriers to exercise participation. Recently, the use of mobile apps has been highlighted as a remotely supervised exercise management strategy. OBJECTIVE This study aimed to evaluate the effects of home-based exercise management with a customized mobile app on exercise amount, physical activity, and quality of life in patients with parkinsonism. METHODS This was a prospective, open-label, single-arm, pilot study. Participants were encouraged to engage in an 8-week home-based exercise program delivered through a customized app. The primary outcome was the exercise amount. The secondary outcomes were International Physical Activity Questionnaire (IPAQ), Parkinson’s Disease Questionnaire-39 (PDQ-39), and Geriatric Depression Scale (GDS). RESULTS A total of 21 participants completed the intervention and assessment (mean age: 72 years; women: 17/21, 81%; men: 4/21, 19%). The participants reported a significant increase in the total amount of exercise (baseline: 343.33±206.70 min/week; 8-week follow up: 693.10±373.45 min/week; P<.001) and in the amount of each exercise component including stretching, strengthening, balance and cooperation, and oral-motor and vocal exercise after 8 weeks. The analysis of secondary outcomes revealed significant improvements in the IPAQ (P=.006), PDQ-39 (P=.02), and GDS (P=.04) scores. The usability of the program with the mobile app was verified based on the positive responses such as “intention to use” and “role expectation for rehabilitation.” CONCLUSIONS Exercise management with a customized mobile app may have benefits for improving exercise adherence, physical activity, depression, and quality of life in patients with parkinsonism. This supervised home-based, technology-based, reinforcing, and multimodal exercise management strategy should be recommend to patients with parkinsonism. In addition, this program may be useful as an alternative exercise management strategy during the COVID-19 pandemic. Additional clinical trials are needed to evaluate the efficacy of this exercise program in a large population and to confirm its disease-modifying effects.