Experiences from the implementation of physical therapy via telehealth for individuals with Parkinson disease during the COVID-19 pandemic

Abstract

Purpose

To (1) determine the characteristics and participation rate of adults with Parkinson disease (PD) in physical therapy (PT) delivered via telehealth, (2) identify the outcome measures and interventions implemented, (3) determine the safety of and (4) patient and therapist satisfaction with PT via telehealth in a clinic specializing in the care of people with PD during the coronavirus pandemic.

Materials & Methods

A retrospective analysis of PT services via telehealth was conducted. Participating patients completed a satisfaction survey. Physical therapists (PTs) who delivered this care were interviewed. Three coders conducted thematic analysis of interviews. Descriptive statistics described the participation rate, demographics, outcome measures, interventions, and safety.

Results

There was a 71.4% participation rate. Participants (n = 55) were white (96%), non-Hispanic (100%), older adult (mean = 69.5 years (8.3)) males (65.5%). Non-participants (n = 22) had similar demographics. Therapists selected patient-reported measures more often than performance-based measures. Therapeutic exercise was the most common intervention. All patients (80% response rate) reported satisfaction with their experience. PTs reported the home enhanced specificity of training but impeded evaluation. Therapists endorsed a hybrid model for future practice.

Conclusions

Patients reported satisfaction with PT via telehealth during the pandemic. A hybrid model may support optimal delivery of PT.

IMPLICATIONS FOR REHABILITATION

• Physical therapy via telehealth for patients with Parkinson disease was acceptable to patients and physical therapists in our study.

• Physical therapy via telehealth was safe for people with Parkinson disease in our study, although availability and benefits may not be reaching all populations equitably.

• Both physical therapists and patients endorse a hybrid model of care (a combination of in-person and remote assessment and treatment) to profit from the strengths of in-person and virtual formats while minimizing barriers to access.

Keywords:

• Telehealth
• physical therapy
• Parkinson disease
• COVID-19
• pandemic

Acknowledgements

The authors would like to acknowledge the patients and therapists that shared their experiences and perspectives with us for this study. We are grateful for their time and energy. We are also appreciative of the time and effort that physical therapy students, Jing Chen, Aaronn Gu, and Steven Zachariadis, devoted to this project.

Disclosure statement

Dr. Ellis has received funding from the National Institutes of the Health, the American Parkinson Disease Association and the Parkinson’s Foundation to support research and/or educational and outreach programs. Drs. Colón-Semenza, Schwartz and Zajac and Ms. Darbandsari declare that they have no conflicts of interest to report.

Additional information

Funding

The study was supported by the American Parkinson Disease Association but there is not a grant number available. They support our National Rehab Resource Center / exercise help-line on an annual basis.