Feasibility of online PD SAFEx™ exercise rehabilitation for symptom improvements of Parkinson's disease: A pilot study

BACKGROUND: Parkinson's Disease (PD) is a neurodegenerative disorder affecting both motor and cognitive symptoms. While medications show some improvement in motor symptoms, cognitive symptoms can worsen. In-person exercise programs, such as PD SAFEx (TM), are an important adjunct therapy in improving symptoms. However, coronavirus disease 2019 (COVID-19) limited in-person exercise interventions. Therefore, there is a need to investigate the effectiveness of online exercise delivery. OBJECTIVE: To identify (1) whether an online exercise intervention can achieve similar results to an identical in-person intervention and (2) if online PD SAFEx (TM) can alter the cognitive decline of PD patients. METHODS: 20 participants with idiopathic PD participated in a 12-week online PD SAFEx (TM) program and were compared to 73 participants from in-person PD SAFEx (TM). The primary outcome measure was the Unified Parkinson's Disease Rating Scale-III measured before/after intervention. Three secondary cognitive measures were collected with the online group. RESULTS: Main effect of time on UPDRS-III scores of both groups were found (F(1,92) = 35.555, p < 0.001). No interaction was found between in-person and online groups (F(1,1) = 0.052, p = 0.820). TMT B in the online group showed significant improvements in executive function (F(1,17) = 7.095, p = 0.016). CONCLUSIONS: Online and in-person PD SAFEx (TM) both achieved clinically significant UPDRS-III improvement and are statistically equivalent. Online PD SAFEx (TM) reduced cognitive symptoms seen during COVID-19.