The Efficacy of Tai Chi and Stretching Exercises Based on a Smartphone Application for Patients With Parkinson's Disease: A Protocol for a Randomized Controlled Trial

Abstract

Introduction: Parkinson's disease (PD) is a common neurodegenerative disease that seriously impairs patients' quality of life, and increases the burden of patients and caregivers. Both drugs and exercise can alleviate its motor and non-motor symptoms, improving the quality of life for PD patients. Telehealth, an increasingly popular tool, makes rehabilitation accessible at home, overcoming the inconvenience of traffic and scheduling. Care-PD is a phone application designed for rehabilitation training, which provides Tai Chi and stretching exercises through tutorial videos as well as an online evaluation system. In this protocol, we will explore the efficacy of Tai Chi and stretching exercises as a PD rehabilitation therapy based on the smartphone application Care-PD.Methods and Analysis: A double-blind, parallel randomized controlled trial will be conducted in this study. The recruitment, intervention, and evaluation processes will be implemented through the Care-PD application. Persons with PD will fill out questionnaires on Activities of Daily Living (ADL), upload the latest case report, and sign the informed consent form in the application. Afterward, doctors and researchers will screen and enroll 180 participants who will be randomly (1:1:1) assigned to Tai Chi group, stretching exercises group, or control group. The subjects will participate in a 1-h exercise session three times per week for 12 weeks, ending with another 4 weeks of follow-up study. Each exercise session includes 10 min of warm-up, 45 min of exercise, and 5 min of cool-down. The primary outcomes are Motor Aspects of Experiences of Daily Living and the 39-item Parkinson's disease Questionnaire. The secondary outcomes include the 9-item Wearing-Off Questionnaire, the Freezing of Gait Questionnaire, the Caregiver Strain Index, Non-motor Experiences of Daily Living, ADL, and Morse Fall Scale. All assessments will be performed at baseline, week 12 and 16.Discussion: Care-PD integrates subject recruitment, intervention, and evaluation, providing a new perspective on clinical rehabilitation for persons with PD. This study will evaluate the efficacy of Tai Chi and stretching exercises on patients' quality of life and disease progression based on a smartphone application. We aim to provide a new rehabilitation training platform for persons with PD.Ethics and Dissemination: This study was approved by the Scientific Research Ethics Committee (102772020RT132) of Shanghai University of Sport. Data collection begins after the approval of the ethics committee. The participants must sign an informed consent form before enrollment. The results will be published in relevant journals, seminars, and be disseminated among rehabilitation practitioners and patients with PD.Clinical Trial Registration: Chinese Clinical Trial Registry, identifier [ChiCTR2100042096]. Registered on January 13, 2021.

The use of virtual complementary and integrative therapies by neurology outpatients: An exploratory analysis of two cross-sectional studies assessing the use of technology as treatment in an academic neurology department in New York City

“…Prior to the pandemic, research has shown that virtual-based CITs are potentially beneficial to patients with neurological conditions who want to improve self-care and track their symptoms. 8 , 20 Studies demonstrated that the use of virtual CITs put increased responsibility on the patient, which enabled them to feel more involved in their care and motivate them to maintain a healthy lifestyle. 8 , 20 During the pandemic, and with the associated increased use of telehealth services, 4 we found several key observations regarding CIT use: (1) patients who reported postponing medical treatment were more likely to seek CITs; (2) younger patients were more likely to employ mobile/virtual CITs; (3) virtual exercise, virtual psychotherapy, and relaxation/meditation smartphone applications were the most reported types of virtual CITs employed; (4) patients who reported postponing medical treatment were more likely to seek complementary and integrative therapies (CITs).…”

“…8,20 Studies demonstrated that the use of virtual CITs put increased responsibility on the patient, which enabled them to feel more involved in their care and motivate them to maintain a healthy lifestyle. 8,20 During the pandemic, and with the associated increased use of telehealth services, 4 we found several key observations regarding CIT use: (1) patients who reported postponing medical treatment were more likely to seek CITs; (2) younger patients were more likely to employ mobile/virtual CITs;…”

“…However, these studies had small sample sizes with select patient populations, and many only focused on specific CIT applications such as tai chi and stretching, there is a clear gap in the literature on the use of mobile/virtual/telehealth CITs as a whole across larger patient populations. [8][9][10][11][12] Hence, it becomes increasingly important to assess overall CIT usage in more patient populations.…”