Telerehabilitation: A Practical Remote Alternative for Coaching and Monitoring Physical Kinetic Therapy in Patients with Mild and Moderate Disabling Parkinson’s Disease during the COVID-19 Pandemic
Table 1
Participant selection criteria.
Baseline inclusion criteria
Mild or moderately disabling, idiopathic PD (score range 1.5-3 on HY scale, in “OFF” state) No history of positive COVID-19, nor recent contact with positive people Not currently receiving physical therapy or occupational therapy Able to stand up and walk independently 6 meters Able to follow verbal commands Able to provide informed consent (agreement to be filmed and photographed while maintaining the elements of confidentiality) Stable pharmacological treatment for the last six months Access to ICT devices and services appropriate for providing at-home motor telerehabilitation: smartphone, iPhone, tablet, or PC, Internet access Personal automatic digital sphygmomanometer and a pulse oximeter (a few subjects had a smartwatch) The caregiver’s presence and family mediation were mandatory (for technical assistance and safety during the telerehabilitation kinetic session)
Exclusion criteria to maintain safety
Age over 70 Severe comorbidities: History of cardiac conditions (myocardial infarction, uncontrolled arrhythmias, and congestive heart failure 3-4 NYHA) History of chronic obstructive pulmonary disease (COPD) and use of supplemental oxygen History of stroke, cerebral tumor, and severe traumatic brain injury Orthostatic hypotension (systolic BP < 110 mmHg) or uncontrolled resting hypertension (systolic BP > 180 mmHg or diastolic >110 mmHg) Uncontrolled diabetes mellitus Disabling arthritis or severe pain (that could limit physical activity) Visual and auditory impairments that disrupt audio-video interactions Cognitive impairments (dementia and aphasia) that prevent the patient from understanding audio-video information and signing the ethical consent form. Patients quantified ≤3 with the Mini-Cog test History of same-level falls occurred in the last six months DBS (deep brain stimulation) or continuous duodenal levodopa infusion (levodopa/carbidopa intestinal gel)
