Abstract Details

Title A Novel Tele-rehabilitation Program Aimed at Fall Prevention in Parkinson’s Disease

Topic Neuro-rehabilitation

Presentation(s) P12 - Poster Session 12 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-007

Objective To examine the feasibility and preliminary efficacy of using teleconferencing to provide a 10-week novel fall-prevention program comprised of virtual occupational therapy (OT) and physical therapy (PT) using a mobile platform to persons with Parkinson’s Disease (PWPs) and their care-partners (CPs). Herein, we report the final results of this ongoing study that evolved out of the COVID-19 pandemic.

Background New approaches in assessing fall-risk and preventing falls are needed given the profound impact of falls, most of which occur in the home. Telemedicine has recently become widely-adopted as a valuable method of increasing access to care and patients’ home environments. Programs targeting individual fall-risk in the home among PWPs are scarce.

Design/Methods We piloted a novel 10-week virtual fall prevention program comprised of personalized and real-time tele-PT and tele-OT visits following an initial in-person evaluation. Participants were recruited from our tertiary Movement Disorders clinic. The program included four tele-PT and tele-OT visits over the course of 10 weeks with follow-up at 6 months. Feasibility was defined by adherence, retention, and safety. Preliminary efficacy was defined by self-reported and objective measures of balance confidence (Activities-Specific Balance Scale, ABC), quality-of-life (PDQ-39), progress towards PT/OT goals (Goal Attainment Scale, GAS), home-safety recommendations adherence, Five-Times-Sit-to-Stand assessment, and Rapid-Turns-Test.

Results Fifteen PWP+CP pairs enrolled with 120/120 tele-visits completed with zero adverse events and drop-outs. Short-term efficacy significantly improved using the GAS at 10-weeks compared to long-term at 6 months (PT:p<0.005, OT:p=0.008). Contrarily, a component of the tele-OT visits included an interactive “virtual home safety evaluation” which demonstrated 87% and 91% compliance with short and long-term modifications respectively. Fall diaries revealed 100% of falls took place within the home, with 75% deemed as modifiable.

Conclusions A home-based teleconferencing-based rehabilitative intervention to modify individual fall-risk for PWP+CP pairs is feasible, safe, and demonstrates some preliminary efficacy with respect to OT-related practices.

Authors/Disclosures
Andrea Hernandez PRESENTER	Ms. Hernandez has nothing to disclose.
Mitra Afshari, MD (Rush University Movement Disrders)	Dr. Afshari has received research support from Consolidated Anti-Aging Foundation . Dr. Afshari has received research support from Parkinson Study Group.
Christopher Goetz, MD, FAAN (Rush University Medical Center)	The institution of Dr. Goetz has received research support from Michael J. Fox Foundation. The institution of Dr. Goetz has received research support from NIH. The institution of Dr. Goetz has received research support from Department of Defense. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care.

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