Feasibility and acceptability of a multi-components intervention (PDConnect) to support physical activity in people living with Parkinson's: a mixed methods study.

Jones, Julie Claire

Abstract

The benefits of physical activity (PA) for people with Parkinson's are widely acknowledged. To date, research has focussed on the effectiveness of PA interventions, with limited research exploring the optimum means of supporting people living with Parkinson's to change their PA behaviour. A narrative review was undertaken to provide context and underpin the development of a multi-component PA intervention (PDConnect) for people with Parkinson's. PDConnect combines specialist physiotherapy, group-based PA, and self-management with the aim of promoting increased PA and PA self-management. This study was undertaken to determine the feasibility and acceptability of the PDConnect intervention. This study adopted a pragmatist worldview and employed mixed methods. A convergent sequential mixed-methods design was adopted and delivered online via Microsoft Teams. A convenience sample of 31 people with Parkinson's were recruited and randomised into two groups: (i) the usual care group received standard physiotherapy once a week for six-weeks. (ii) the PDConnect group received once a week for six weeks physiotherapy that combined PA, education and behaviour change interventions delivered by a Parkinson's specialist physiotherapist. This was followed by 12 weekly sessions of group-based PA by a fitness instructor specially trained in Parkinson's. Participants were then contacted by the fitness instructor once a month for three months to support PA engagement. Primary feasibility data were collected during the study, with acceptability assessed via semi-structured interviews. Secondary outcomes encompassing motor, non-motor, PA, and health and well-being measures were assessed at baseline, and at six, 18 and 30 weeks. PDConnect was shown to be feasible and safe. The sample was recruited in 12 weeks, and the retention rate was 74%. Outcome measure response and activity diary return rate was high (>95%, 84% respectively). PDConnect attendance was high: 100% for the physiotherapy component and 83% for the group-based exercise component. Participants were very satisfied with PDConnect and perceived that participation increased exercise confidence and knowledge and understanding of Parkinson's. Participation positively impacted Parkinson's symptoms, with perceived improvements in flexibility, muscle strength, PA levels and endurance. Fifty percent of participants receiving PDConnect reported that they were much improved compared to 10% in the usual care group. PDConnect study resources were deemed acceptable. Intervention fidelity was high, with 89% of the physiotherapy and 88% of the group-based exercise delivered as planned. All progression criteria were met, except for participant retention which fell one percent below the a priori criterion. PDConnect is feasible to deliver and rated as highly acceptable among people with Parkinson's. A large-scale trial is required to fully evaluate the effectiveness of PDConnect. Sampling within a future trial needs to include under-represented groups and broader cultural and ethical diversity. In addition, appropriate funding is required to minimise digital exclusion and optimise digital literacy. Minor modifications to the participant manual to support personalisation, and further consideration of type of PA monitor is also recommended. Further consultation with the Parkinson's community is required to guide how to optimise social connection when delivering PA online and to inform the selection of future outcome measures.

Citation

JONES, J.C. 2023. Feasibility and acceptability of a multi-components intervention (PDConnect) to support physical activity in people living with Parkinson's: a mixed methods study. Robert Gordon University, PhD thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2270864

• Thesis Type: Thesis
• Deposit Date: Mar 12, 2024
• Publicly Available Date: Mar 12, 2024
• DOI: https://doi.org/10.48526/rgu-wt-2270864
• Keywords: Parkinson's disease; Parkinson's patients; Physical activity; Behaviour change; Self-management
• Public URL: https://rgu-repository.worktribe.com/output/2270864
• Award Date: Aug 31, 2023