Field Initiated Project Programs Motivational Interviewing and Physical Activity Change in Parkinson’s Disease

Project: Research project

Project Details

Description

The goal of this application is to test the efficacy of a 6 month telephone-based motivational interviewing coaching intervention and a smartphone application for self-monitoring to improve physical activity in persons with Parkinson’s disease (PD). PD is the second most common neurodegenerative disorder that affects up to 1 million people in the United States. It has no known cure. PD results in disabling symptoms of rigidity, bradykinesia (slow movement), resting tremor, and postural instability. The annual economic impact of PD in the United States is estimated at $10.8 billion. The number of individuals with PD is expected to double by 2030. Persons with PD face significant declines in mobility and activities of daily living resulting in loss of independence and compromised health-related quality of life. There is a substantial body of evidence demonstrating the benefit of exercise on PD-related disability and some data pointing to potential neuroprotective effects of exercise leading to less loss of motor function. Motivational interviewing (MI) is a patient-centered guiding method for enhancing intrinsic motivation to change. MI has been successfully used with persons with physical disabilities due to a variety of conditions to help them increase their level of physical activity. However, there are no published findings presenting a MI intervention to increase physical activity and quality of life in persons with PD. Several studies have reported benefits to using technology in behavioral interventions. Self-monitoring using a smartphone application may assist in maintaining participant engagement and subsequent behavior change. However, there are no published findings using a smartphone application to self-monitor physical activity in persons with PD.
Aims: The specific aims of this application are to: (1) Develop a smartphone application for self-monitoring of physical activity for a population of persons with PD; (2) Test the efficacy of two physical activity promotion interventions for improving physical activity (primary outcome), balance (secondary outcome), and quality of life (secondary outcome) in persons with PD; and (3) Assess persistent effects of the interventions at 9 months (3 months post-intervention) in persons with PD.
Design: This application is a randomized controlled clinical trial using a 2x2 factorial design. The project will begin with focus groups of persons with PD to assist in developing the smartphone application for self-monitoring. For the clinical trial, participants will be recruited from a PD registry at Northwestern Medical Group and randomly assigned to one of the four intervention groups: education (control intervention); MI intervention only, smartphone self-monitoring application only; and both MI + smartphone interventions. Sixty-four participants will be assessed for physical activity, balance, and quality of life at baseline, 3, 6, and 9 months to assess for changes in the outcomes.
Significance: This application focuses on increasing physical activity in persons with PD which we believe will lead to improvements in balance and quality of life in this patient population. Utilizing an intervention that has shown positive increase in physical activity in a different population will help translate these findings to other patient populations in other health care settings. This research will potentially provide persons with PD, a chronic degenerative disease, with a non-pharmacologic option for treatment to increase function and quality of life that is long lasting.
StatusActive
Effective start/end date9/30/159/29/20

Funding

  • Rehabilitation Institute of Chicago (81421//901F0093-01-00)
  • National Institute on Disability, Independent Living, and Rehabilitation Research (81421//901F0093-01-00)

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