Digital Intervention Promoting Physical Activity in People Newly Diagnosed with Parkinson's Disease: Feasibility and Acceptability of the Knowledge, Exercise-Efficacy and Participation (KEEP) Intervention

Abstract

Background: Exercise promotion interventions for people with Parkinson's disease (PD) are often offered on a face-to-face basis, follow a generic "one-size-fit-all" approach, and are not typically delivered at diagnosis. Considering PD's heterogenous nature, the existing evidence on the merits of exercise on symptom management and the expressed wishes of people living with PD for access to timely and tailored evidence-based information, there is a demand for interventions that are easily accessible, scalable and co-designed with people living with PD.

Objective: Evaluate the feasibility and acceptability of a co-designed digital intervention promoting exercise and physical activity, in people newly diagnosed with PD.

Methods: Thirty people living with PD for less than one year participated in an assessor-blinded randomized feasibility trial from June 2022 to April 2023. The intervention group received the 8-week Knowledge, Exercise Efficacy and Participation (KEEP) intervention comprising 6 interactive digital modules and 4 online live group discussions facilitated by a specialist physiotherapist. Assessments were performed at baseline, post intervention and at 6-month follow up.

Results: Thirty participants were recruited to target with a 64% recruitment rate (30/47). All but one participant completed the 6-month follow-up assessment. There was high retention (97%), module completion (91%), and online discussion attendance (88%). Outcome measure collection was feasible, including accelerometer data with a daily average wear time of 23.9 hours (SD:0.295).

Conclusions: The KEEP intervention was feasible and acceptable in people newly diagnosed with PD. A larger trial is needed to assess intervention efficacy and correlation between knowledge, self-efficacy, and activity levels.

Trial registration: ClinicalTrials.gov NCT05253040.

Keywords: Parkinson’s disease; Physical activity; co-design; digital health; exercise promotion; feasibility study; physical literacy.

Fig. 1

Co-design approach to develop KEEP and emergent themes.

Fig. 2

The KEEP intervention participant flow in the online platform. The intervention includes multimedia education about exercise and physical activity and their importance in Parkinson’s disease (PD), delivered by healthcare professionals specializing in PD and people living with Parkinson’s. The content is tailored to the participant and based on their answers during the profile set up. Interactive functions include multiple choice questions, goal setting, and activity diary which are also provided for participants to download.

Fig. 3

Flow diagram of feasibility study for full details.

Fig. 4

Box plot of average daily wear time of accelerometers during the study period.

Fig. 5

Likert responses from participant on the acceptability of the KEEP intervention.