Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease

Authors

  • Chelsea E. Macpherson Teachers College, Columbia University
  • Julie Fineman Marist College
  • Anuja Chandrana Teachers College, Columbia University
  • Lori Quinn Teachers College, Columbia University

DOI:

https://doi.org/10.5195/ijt.2023.6592

Keywords:

Algorithm (Decision tree), Examination, Parkinson disease, Physical therapy, Telehealth

Abstract

Scope: The rapid transition to telehealth following the COVID-19 pandemic raised challenges for remote delivery of physical therapy. One challenge was identifying outcome measures for people with Parkinson Disease (PwP) that could safely be conducted via telehealth. This paper evaluates the feasibility of a telehealth physical therapy examination battery for PwP in early to middle stage of disease progression. Methodology: We reviewed recommended outcome measures from the American Physical Therapy Association’s Academy of Neurologic Physical Therapy (ANPT) Parkinson Evidence Database to Guide Effectiveness (EDGE) document and evaluated their appropriateness for remote administration. A clinical decision tree was created to streamline the examination process, incorporating elements of the ANPT movement analysis of tasks as a movement screen. The examination battery was then conducted on three PwP and evaluated for safety and feasibility. Conclusion: This physical therapy telehealth examination battery provides physical therapists with a method to conduct safe and efficient remote assessments for PwP.

  

References

Abdolahi, A., Bull, M. T., Darwin, K. C., Venkataraman, V., Grana, M. J., Dorsey, E. R., & Biglan, K. M. (2016). A feasibility study of conducting the Montreal Cognitive Assessment remotely in individuals with movement disorders. Health Informatics Journal, 22(2), 304–311. https://doi.org/10.1177/1460458214556373

APTA Guide to Physical Therapy Practice 4.0. (2023). American Physical Therapy Association.

Beitz, J. M. (2014). Parkinson’s disease: A review. Frontiers in Bioscience (Scholar Edition), 6(1), 65–74. https://doi.org/10.2741/s415

Bennell, K. L., Lawford, B. J., Metcalf, B., Mackenzie, D., Russell, T., Van Den Berg, M., Finnin, K., Crowther, S., Aiken, J., Fleming, J., & Hinman, R. S. (2021). Physiotherapists and patients report positive experiences overall with telehealth during the COVID-19 pandemic: A mixed-methods study. Journal of Physiotherapy, 67(3), 201–209. https://doi.org/10.1016/j.jphys.2021.06.009

Bianchini, E., Onelli, C., Morabito, C., Alborghetti, M., Rinaldi, D., Anibaldi, P., Marcolongo, A., Salvetti, M., & Pontieri, F. E. (2022). Feasibility, safety, and effectiveness of telerehabilitation in mild-to-moderate Parkinson’s disease. Frontiers in Neurology, 13, 909197. https://doi.org/10.3389/fneur.2022.909197

Brusse, K. J., Zimdars, S., Zalewski, K. R., & Steffen, T. M. (2005). Testing functional performance in people with Parkinson disease. Physical Therapy, 85(2), 134–141.

Buabbas, A. J., Albahrouh, S. E., Alrowayeh, H. N., & Alshawaf, H. (2022). Telerehabilitation during the COVID-19 pandemic: Patients and physical therapists’ experiences. Medical Principles and Practice, 31(2), 156–164. https://doi.org/10.1159/000523775

Colón-Semenza, C., Zajac, J. A., Schwartz, A., Darbandsari, P., & Ellis, T. D. (2023). Experiences from the implementation of physical therapy via telehealth for individuals with Parkinson disease during the COVID-19 pandemic. Disability and Rehabilitation, 0(0), 1–9. https://doi.org/10.1080/09638288.2023.2202418

Cubo, E., Garcia-Bustillo, A., Arnaiz-Gonzalez, A., Ramirez-Sanz, J. M., Garrido-Labrador, J. L., Valiñas, F., Allende, M., Gonzalez-Bernal, J. J., Gonzalez-Santos, J., Diez-Pastor, J. F., Jahouh, M., Arribas, J., & Trejo, J. (2021). Adopting a multidisciplinary telemedicine intervention for fall prevention in Parkinson’s disease. Protocol for a longitudinal, randomized clinical trial. PloS One, 16(12), e0260889. https://doi.org/10.1371/journal.pone.0260889

Dal Bello-Haas, V., Klassen, L., Sheppard, M. S., & Metcalfe, A. (2011). Psychometric properties of activity, self-efficacy, and quality-of-life measures in individuals with Parkinson disease. Physiotherapy Canada. Physiotherapie Canada, 63(1), 47–57. https://doi.org/10.3138/ptc.2009-08

Diener, I., Kargela, M., & Louw, A. (2016). Listening is therapy: Patient interviewing from a pain science perspective. Physiotherapy Theory & Practice, 32(5), 356–367. https://doi.org/10.1080/09593985.2016.1194648

Dorsey, E. R., Sherer, T., Okun, M. S., & Bloem, B. R. (2018). The emerging evidence of the Parkinson pandemic. Journal of Parkinson’s Disease, 8(Suppl 1), S3–S8. https://doi.org/10.3233/JPD-181474

Duncan, R. P., Leddy, A. L., & Earhart, G. M. (2011). Five Times Sit-to-Stand Test performance in Parkinson’s disease. Archives of Physical Medicine and Rehabilitation, 92(9), 1431–1436. https://doi.org/10.1016/j.apmr.2011.04.008

Ellis, T. D., Colón-Semenza, C., DeAngelis, T. R., Thomas, C. A., Saint-Hilaire, M.-H., Earhart, G. M., & Dibble, L. E. (2021). Evidence for early and regular physical therapy and exercise in Parkinson’s disease. Seminars in Neurology, 2(41), 189–205. https://doi.org/10.1055/s-0041-1725133

Flynn, A., Preston, E., Dennis, S., Canning, C. G., & Allen, N. E. (2023). Utilising telehealth to support exercise and physical activity in people with Parkinson disease: A program evaluation using mixed methods. BMC Health Services Research, 23(1), 224. https://doi.org/10.1186/s12913-023-09194-0

Giladi, N., Tal, J., Azulay, T., Rascol, O., Brooks, D. J., Melamed, E., Oertel, W., Poewe, W. H., Stocchi, F., & Tolosa, E. (2009). Validation of the freezing of gait questionnaire in patients with Parkinson’s disease. Movement Disorders: Official Journal of the Movement Disorder Society, 24(5), 655–661. https://doi.org/10.1002/mds.21745

Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez-Martin, P., Poewe, W., Sampaio, C., Stern, M. B., Dodel, R., Dubois, B., Holloway, R., Jankovic, J., Kulisevsky, J., Lang, A. E., Lees, A., Leurgans, S., LeWitt, P. A., Nyenhuis, D., … Movement Disorder Society UPDRS Revision Task Force. (2008). Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Movement Disorders, 23(15), 2129–2170. https://doi.org/10.1002/mds.22340

Grace, J., Mendelsohn, A., & Friedman, J. H. (2007). A comparison of fatigue measures in Parkinson’s disease. Parkinsonism & Related Disorders, 13(7), 443–445. https://doi.org/10.1016/j.parkreldis.2006.09.001

Harrell, R. G., Schubert, M. C., Oxborough, S., & Whitney, S. L. (2022). Vestibular rehabilitation telehealth during the SAEA-CoV-2 (COVID-19) pandemic. Frontiers in Neurology, 12. https://www.frontiersin.org/articles/10.3389/fneur.2021.781482

Kava, C. M., Fishleder, S., Steinman, L., Petrescu-Prahova, M., Schrodt, L., & Harris, J. R. (2020). Provider–patient communication and involvement in physical activity programs among patients receiving physical therapy services: A qualitative study. Journal of Applied Gerontology, 39(9), 1000–1007. https://doi.org/10.1177/0733464819847402

Kegelmeyer, D., Ellis, T., Esposito, A., Gallagher, R., Harro, C., Hoder, J., Hussey, E., & Oneal, S. (n.d.). Parkinson evidence database to guide effectiveness. Academy of Neurologic Physical Therapy. Retrieved July 17, 2023, from https://www.neuropt.org/practice-resources/neurology-section-outcome-measures-recommendations/parkinson-disease

King, L. A., Priest, K. C., Salarian, A., Pierce, D., & Horak, F. B. (2012). Comparing the Mini-BESTest with the Berg Balance Scale to evaluate balance disorders in Parkinson’s disease. Parkinson’s Disease, 2012, 375419. https://doi.org/10.1155/2012/375419

Kobayashi, E., Himuro, N., & Takahashi, M. (2017). Clinical utility of the 6-min walk test for patients with moderate Parkinson’s disease. International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation, 40(1), 66–70. https://doi.org/10.1097/MRR.0000000000000205

Lai, B., Bond, K., Kim, Y., Barstow, B., Jovanov, E., & Bickel, C. S. (2020). Exploring the uptake and implementation of tele-monitored home-exercise programmes in adults with Parkinson’s disease: A mixed-methods pilot study. Journal of Telemedicine and Telecare, 26(1–2), 53–63. https://doi.org/10.1177/1357633X18794315

Leddy, A. L., Crowner, B. E., & Earhart, G. M. (2011). Utility of the Mini-BESTest, BESTest, and BESTest sections for balance assessments in individuals with Parkinson disease. Journal of Neurologic Physical Therapy: JNPT, 35(2), 90–97. https://doi.org/10.1097/NPT.0b013e31821a620c

Mak, M. K., Wong-Yu, I. S., Shen, X., & Chung, C. L. (2017). Long-term effects of exercise and physical therapy in people with Parkinson disease. Nature Reviews. Neurology, 13(11), 689–703. https://doi.org/10.1038/nrneurol.2017.128

Maranhão-Filho, P. A., Maranhão, E. T., Lima, M. A., & Silva, M. M. da. (2011). Rethinking the neurological examination II: Dynamic balance assessment. Arquivos de Neuro-Psiquiatria, 69(6), 959–963. https://doi.org/10.1590/S0004-282X2011000700022

Osborne, J. A., Botkin, R., Colon-Semenza, C., DeAngelis, T. R., Gallardo, O. G., Kosakowski, H., Martello, J., Pradhan, S., Rafferty, M., Readinger, J. L., Whitt, A. L., & Ellis, T. D. (2022). Physical therapist management of Parkinson disease: A clinical practice guideline from the American Physical Therapy Association. Physical Therapy, 102(4), pzab302. https://doi.org/10.1093/ptj/pzab302

Quinn, L., Macpherson, C., Long, K., & Shah, H. (2020). Promoting physical activity via telehealth in people with Parkinson disease: The path forward after the COVID-19 pandemic? Physical Therapy, 100(10), 1730–1736. https://doi.org/10.1093/ptj/pzaa128

Quinn, L., Riley, N., Tyrell, C. M., Judd, D. L., Gill-Body, K. M., Hedman, L. D., Packel, A., Brown, D. A., Nabar, N., & Scheets, P. (2021). A framework for Movement Analysis of Tasks: Recommendations from the Academy of Neurologic Physical Therapy’s Movement System Task Force. Physical Therapy, 101(9), pzab154. https://doi.org/10.1093/ptj/pzab154

Radder, D. L. M., Sturkenboom, I. H., van Nimwegen, M., Keus, S. H., Bloem, B. R., & de Vries, N. M. (2017). Physical therapy and occupational therapy in Parkinson’s disease. International Journal of Neuroscience, 127(10), 930–943. https://doi.org/10.1080/00207454.2016.1275617

Rafferty, M. R., Nettnin, E., Goldman, J. G., & MacDonald, J. (2021). Frameworks for Parkinson’s disease rehabilitation addressing when, what, and how. Current Neurology and Neuroscience Reports, 21(3), 12. https://doi.org/10.1007/s11910-021-01096-0

Schenkman, M., Moore, C. G., Kohrt, W. M., Hall, D. A., Delitto, A., Comella, C. L., Josbeno, D. A., Christiansen, C. L., Berman, B. D., Kluger, B. M., Melanson, E. L., Jain, S., Robichaud, J. A., Poon, C., & Corcos, D. M. (2018). Effect of high-intensity treadmill exercise on motor symptoms in patients with de novo Parkinson disease: A phase 2 randomized clinical trial. JAMA Neurology, 75(2), 219–226. https://doi.org/10.1001/jamaneurol.2017.3517

Seron, P., Oliveros, M.-J., Gutierrez-Arias, R., Fuentes-Aspe, R., Torres-Castro, R. C., Merino-Osorio, C., Nahuelhual, P., Inostroza, J., Jalil, Y., Solano, R., Marzuca-Nassr, G. N., Aguilera-Eguía, R., Lavados-Romo, P., Soto-Rodríguez, F. J., Sabelle, C., Villarroel-Silva, G., Gomolán, P., Huaiquilaf, S., & Sanchez, P. (2021). Effectiveness of telerehabilitation in physical therapy: A rapid overview. Physical Therapy, 101(6), pzab053. https://doi.org/10.1093/ptj/pzab053

Shih, H.-J. S., Macpherson, C. E., King, M., Delaney, E., Gu, Y., Long, K., Reid, J., Fineman, J., Yu, G., Rieger, J., Satchidanand, A., Shah, H., Alcalay, R. N., & Quinn, L. (2022). Physical activity coaching via telehealth for people with Parkinson disease: A cohort study. Journal of Neurologic Physical Therapy, 46(4), 240–250. https://doi.org/10.1097/NPT.0000000000000410

Sparrow, D., DeAngelis, T. R., Hendron, K., Thomas, C. A., Saint-Hilaire, M., & Ellis, T. (2016). Highly challenging balance program reduces fall rate in Parkinson disease. Journal of Neurologic Physical Therapy, 40(1), 24–30. https://doi.org/10.1097/NPT.0000000000000111

Steffen, T., & Seney, M. (2008). Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People with Parkinsonism. Physical Therapy, 88(6), 733–746. https://doi.org/10.2522/ptj.20070214

Taghizadeh, G., Martinez-Martin, P., Habibi, S. A. H., Goudarzi, S., Meimandi, M., Dehmiyani, A., Nodehi, Z., Rostami, S., Haji Alizadeh, N., & Mehdizadeh, M. (2022). Psychometric features of brief pain inventory for Parkinson’s disease during medication states. Disability and Rehabilitation, 44(23), 7277–7282. https://doi.org/10.1080/09638288.2021.1977858

Tenforde, A. S., Borgstrom, H., Polich, G., Steere, H., Davis, I. S., Cotton, K., O’Donnell, M., & Silver, J. K. (2020). Outpatient physical, occupational, and speech therapy synchronous telemedicine: A survey study of patient satisfaction with virtual visits during the COVID-19 pandemic. American Journal of Physical Medicine & Rehabilitation, 99(11), 977–981. https://doi.org/10.1097/PHM.0000000000001571

Thomas, S., Reading, J., & Shephard, R. J. (1992). Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Canadian Journal of Sports Science, 17(4), 338–345.

Thwaites, C., Nayyar, R., Blennerhassett, J., Egerton, T., Tan, J., & Bower, K. (2023). Is telehealth an effective and feasible option for improving falls-related outcomes in community-dwelling adults with neurological conditions? A systematic review and meta-analysis. Clinical Rehabilitation, 37(1), 17–46. https://doi.org/10.1177/02692155221133468

van der Kolk, N. M., de Vries, N. M., Kessels, R. P. C., Joosten, H., Zwinderman, A. H., Post, B., & Bloem, B. R. (2019). Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: A double-blind, randomised controlled trial. The Lancet. Neurology, 18(11), 998–1008. https://doi.org/10.1016/S1474-4422(19)30285-6

Vellata, C., Belli, S., Balsamo, F., Giordano, A., Colombo, R., & Maggioni, G. (2021). Effectiveness of telerehabilitation on motor impairments, non-motor symptoms and compliance in patients with Parkinson’s disease: A systematic review. Frontiers in Neurology, 12. https://www.frontiersin.org/articles/10.3389/fneur.2021.627999

Walsh, C. B., Cahalan, R., Hinman, R. S., & Sullivan, K. O. (2022). Psychometric properties of performance-based measures of physical function administered via telehealth among people with chronic conditions: A systematic review. PLoS One, 17(9), e0274349. https://doi.org/10.1371/journal.pone.0274349

Zischke, C., Simas, V., Hing, W., Milne, N., Spittle, A., & Pope, R. (2021). The utility of physiotherapy assessments delivered by telehealth: A systematic review. Journal of Global Health, 11, 04072. https://doi.org/10.7189/jogh.11.04072

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Published

2023-12-12

How to Cite

Macpherson, C. E., Fineman, J., Chandrana, A., & Quinn, L. (2023). Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease. International Journal of Telerehabilitation, 15(2). https://doi.org/10.5195/ijt.2023.6592

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Section

Physical Therapy Telehealth