The Effects of a Telehealth Exercise Program on Self-efficacy and Adherence in Individuals with Parkinson's disease

Exercise interventions for people with Parkinson’s disease (PD) have proven beneficial in reducing disability, however adherence to exercise can be a problem for individuals with PD. Self-efficacy (SE) to exercise is a strong determinant of participation in formal exercise programs for individuals with PD. Additionally barriers such as travel distance, cost, and lack of qualified professionals may restrict regular exercise participation. Advances in technology such as videoconferencing may make it easier for people with PD to connect with qualified exercise practitioners and engage in regular exercise programs. The purpose of this study was to compare a telehealth (TH) and self-guided exercise program on SE to exercise and adherence in individuals with PD. A total of twelve adults with idiopathic PD (9 male, 3 female; 69.33 ± 9.42 years) participated in this study, all participants were 1-3 on the Hoehn and Yahr scale. Six participants in the TH participated in private exercise sessions which focused on strength and balance training through videoconferencing (one hour, 2x/week, 12 weeks). Six participants in the self-supervised group were asked to follow the same program as the TH group but through a self-guided exercise manual. SE was evaluated using the Self-efficacy for Exercise Questionnaire 9-item (SEE) and adherence was measured by the number of sessions completed. Secondary outcomes of activities of daily living and fall efficacy were measured through the United Parkinson’s Disease Rating Scale Part II (UPDRS-II) and Fall Efficacy Scale-International (FES-I). All questionnaires were completed before and after the exercise program. Results of the study showed high adherence levels in the TH group (96.7%) compared to the self-supervised group (36.8%). No changes were found in FES-I, UPDRS-II and PDQ-39 scores in either group. Individuals with PD were receptive to TH exercise programming as shown in the high rate of adherence. Although SE to exercise, balance confidence, ability to perform activities of daily living and quality of life did not increase over the 12 week program, our findings suggest that TH may be an effective method to provide exercise programming to individuals with PD.