Boston University Study Demonstrates that mHealth-Supported Exercise Program Benefits People with Parkinson Disease
Boston, MA – February 7, 2019 – The randomized controlled pilot study used the Wellpepper patient engagement platform to examine the comparative effectiveness of mobile-health-supported exercise compared with exercise alone for people with Parkinson disease.
- The comparative-effectiveness study, which took place over a 12-month period, was published in the February 2019 issue (Volume 99, Issue 2) of the journal Physical Therapy.
- It is among the first randomized controlled studies to clinically validate the use of digital health tools in supporting improved patient outcomes.
- The study positively demonstrated the impact of a digital intervention on people with Parkinson disease who were evaluated as sedentary during study enrollment. People with Parkinson disease who were less active when they entered the study, and who used the Wellpepper application during the 12-month period, showed a statistically and clinically significant improvement in their overall mobility scores compared to similar individuals in the control group without the digital intervention.
- The study was led by Terry D. Ellis, PT, PhD, Department of Physical Therapy and Athletic Training and Sargent College of Health and Rehabilitation Sciences at Boston University with a research team from Boston University, the University of New England and Brigham and Women’s Hospital at Harvard Medical School (see full list of authors below).
- Ellis is continuing research in this area at two sites with an NIH-funded clinical trial to further determine the effectiveness of a “connected behavioral approach” against a control group in increasing real-world walking activity in persons with Parkinson disease. The study is onboarding the first subjects this month (February 2019).
“Behavioral change strategies provided through mHealth applications such as those delivered by Ellis and colleagues provide a promising theoretically based and practical approach for helping people with PD (and possibly other chronic disabling conditions) to successfully engage in sustained exercise behavior over the long term,” said Alan M. Jette, PT, PhD, FAPTA and editor in chief of Physical Therapy in an editorial. “As the rehabilitation field shifts from traditional approaches to digital platforms in delivering behavior change interventions, an mHealth application like the one examined in the Ellis et al study holds promise in increasing the reach and scalability of physical therapist services in the digital age.”
This VIDEO demonstrates how the technology was used.
Declining physical activity commonly occurs in people with Parkinson disease (PD) and contributes to significantly reduced functional capacity and overall quality of life. Previous studies have demonstrated the benefits of exercise and physical activity in reducing disability and enhancing quality of life in people with PD.
This study was designed to explore the effectiveness, safety and acceptability of a mobile-health-mediated exercise program in promoting sustained physical activity in people with PD. Essentially, the Wellpepper mobile patient engagement application became a tool for motivating and monitoring behavior change.
There were 51 participants in the study, all of whom had mild-to-moderately severe Parkinson disease. They were divided randomly into two groups – mHealth and active control – and each group was further subdivided into those who were more active when they came into the study and those who were more sedentary.
Over the course of one year, the mHealth group’s outcomes were compared with those of an active control group, looking at daily steps, moderate-intensity minutes and other measures of activity and mobility. Evaluations were made at the beginning and again at the end of 12 months and exercises were provided by physical therapists with expertise in PD.
- mHealth: The mHealth group participated in a technology-mediated exercise program that included walking with a pedometer and engagement in exercises. The Wellpepper mobile patient engagement application was used to provide the take-home exercise instructions (along with videos of each person doing their own exercises in proper form), ongoing text-based communication and support (e.g. changing exercises over time to accommodate progress or health changes) and tracking of physical activity and adherence. Ttracking was visible to participants to monitor their own progress and to researchers.
- Control: The active control group walked with a pedometer, received paper-based exercise instructions and tracked their activity in a paper calendar.
At the end of one year, both groups had increased their daily steps, moderate-intensity minutes and 6-Minute Walk Test, however the Parkinson Disease Questionnaire 39 mobility scores among the subgroup who were less active prior to the study demonstrated a statistically and clinically meaningful improvement.
An abstract of the study is available HERE and the full study can be made available to media upon request. Editorial overview of the study is also available.
Terry D. Ellis, PT, PhD, Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University; JamesT. Cavanaugh, PT, PhD, Department of Physical Therapy, University of New England, Portland, Maine; Tamara DeAngelis, PT, DPT, Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University; Kathryn Hendron, PT, DPT, Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University; Cathi A. Thomas, RN, MS, Department of Neurology, Parkinson’s Disease and Movement Disorders Center, Boston University; Marie Saint-Hilaire, MD, Department of Neurology, Parkinson’s Disease and Movement Disorders Center, Boston University; Karol Pencina, PhD, Research Program in Men’s Health, Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts; and NancyK. Latham, PT, PhD, Research Program in Men’s Health, Aging and Metabolism, Brigham and Women’s Hospital, Harvard Medical School.
About Boston University Center for Neurorehabilitation
The vision of Boston University Center for Neurorehabilitation is to lead the development of evidence based, innovative, theory-based approaches to the rehabilitation of persons with Parkinson disease and other neurological conditions and to disseminate this information on a global level. Lead by Director and assistant professor Dr. Terry Ellis, PhD, PT, NCS, the center is part of the College of Health and Rehabilitation Sciences, Sargent College, Boston University.
Wellpepper is a healthcare technology company with an award-winning and clinically-validated patient engagement platform used by major health systems to improve outcomes and lower costs of care. Wellpepper treatment plans can be customized for each health system’s own protocols and best practices and personalized for each patient. Wellpepper’s patented adaptive notification system helps drive over 70 percent patient engagement with treatment plans. Wellpepper was founded in 2012 to help healthcare organizations lower costs, improve outcomes and improve patient satisfaction. The company is headquartered in Seattle, Washington. Visit http://www.wellpepper.com/ for more information.
Jennifer Allen Newton
Bluehouse Consulting Group, Inc. for Wellpepper