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.