Our objectives are to determine the feasibility and preliminary efficacy of using teleconferencing technology to provide Parkinson’s Disease (PD) patients at risk for falls, alongside their supervising carepartners, a novel telemedicine-based falls-prevention program comprised of tele-physical therapy (PT) and tele-occupational therapy (OT) using a mobile platform (a tablet stand on wheels).

Despite substantial advances in PD motor symptom management, gait and balance dysfunction do not respond adequately to current therapies, increasing risk for falls, fractures, and costly morbidity and mortality.  Telemedicine has established itself as an innovative strategy to improve access to specialty care and neutralize patient-related barriers like time, travel, and cost burden.  Despite the serious implications of falls, there are no universally-adopted and available falls-prevention programs for PD patients. 

In this pilot interventional trial, we designed a 10-week program focused on falls-prevention comprised of an initial and final in-person assessment and 4 televisits, at 2 week intervals, with a neurologic-certified physical therapist and occupational therapist with significant experience working with PD patients.  Feasibility is defined by measures of adherence, retention, and safety.  Preliminary efficacy will be assessed by measures of:  progress towards 3 PT-goals and 2 OT-goals (GAS) and adherence to home safety recommendations; and change in: number of falls and near-falls (Falls Diary), balance confidence (ABC scale), and quality-of-life (PDQ-39).

Eleven patients have enrolled in our pilot trial with 100% adherence to visits, zero drop-outs, and zero adverse events.  Four more patients will be enrolled to finish out the study at n=15 by February 2021, at which point we will analyze the preliminary efficacy variables (of note: to be reported on the poster).

A tele-PT and tele-OT program targeting gait and balance in PD patients at risk of falls is feasible and we hypothesize efficacious as well in certain measures reflecting reduced fall risk.