As an early career researcher and a physiotherapist, attending the 5th World Parkinson Congress in Kyoto, Japan gave me insight into the amazing research being conducted in Parkinson’s. The opportunity to meet world leading experts in my field and discuss their research, as well as receive valuable wisdom and advice about my own research, were highlights of my time in Kyoto.

My research is focussed on investigating the best way to establish an effective and sustainable physiotherapy service for people with Parkinson’s, to help them live well over the course of their disease. The evidence tells us that exercise is beneficial for people with Parkinson’s as it improves mobility (walking speed, step length and walking endurance), balance and quality of life. In people with mild to moderate Parkinson’s disease, exercise can also reduce falls and improve many symptoms. What is less clear is the what is the optimal location, dose or amount of supervision required for exercise to be effective.

In Kyoto, I presented the results of a systematic review which showed that home-based, prescribed exercise improves balance-related activities and walking speed in people with mild to moderate Parkinson’s disease. Furthermore, these improvements are similar to improvements with equivalent centre-based exercise.  This result means that exercise does not have to be completed at a centre. Therapists and people with mild to moderate Parkinson’s can consider the best location for exercise based on the preference of the person with Parkinson’s and the resources available. After presenting the abstract at Kyoto this work was then published later in 2019 in the Journal of Physiotherapy.

Building on this work my research team then started to investigate the feasibility of a predominately home-based exercise program compared to a predominately centre based program, from both the therapist and person with Parkinson’s perspective (trial registration ACTRN 12617000503325). The preliminary results of this trial suggest that remotely monitored home-based exercise is acceptable, feasible and efficient.  A manuscript from this study is currently under development and will hopefully be published soon. The research team are also interested in how we can assist people with Parkinson’s disease to develop skills in exercise self-management, including goal setting, and identifying barriers and facilitators to exercise. Empowering people with Parkinson’s to overcome challenges by effectively seeking and implementing solutions, so that exercise can be maintained over the long term.

In March 2020, due to COVID -19 it was no longer possible to provide group-based therapy in our clinic, so we used the knowledge gained from the aforementioned systematic review and feasibility study to develop a Telehealth service. We were focussed on ensuring we provided a safe and effective home-based service to people with Parkinson’s. People with Parkinson’s were provided with a home exercise program and ongoing monitoring and support provided by telephone and video calls. The home exercise programs were developed using the freely-accessible website PhysioTherapy eXercises which has over 100 exercises that our team specifically developed for people with Parkinson’s.

This was a rapid translation into clinical practice of the research we had presented only nine months ago. Having research evidence to support this transition was extremely helpful when advocating for this change in model of care and in supporting our clients with Parkinson’s. I could confidently tell people with Parkinson’s that exercising at home was beneficial and would help maintain their balance and walking.  One of the many positives which came from providing Telehealth was being able to assess and treat freezing of gait in the client’s own environment, and this is a service we will continue to provide in our clinic. As the COVID-19 restrictions ease in Australia we will turn our focus onto evaluating the effectiveness of this model of care.

I am looking forward to continuing to find ways to make exercise more accessible, effective and sustainable for people with Parkinson’s and hope to present more of my research at the next WPC in Barcelona.

Allyson Flynn is a Lecturer at University of Canberra, Discipline of Physiotherapy and also a PhD Candidate at University of Sydney, Faculty of Medicine and Health.

This research was first shared as an abstract at the WPC 2019 in Kyoto. WPC is pleased to support abstract authors by sharing their ongoing work. Digital files of WPC abstract books can be downloaded from the past three Congresses HERE.

Ideas and opinions expressed in this post reflect that of the author(s) solely. They do not necessarily reflect the opinions of the World Parkinson Coalition®