STEPWISE Parkinson: A smartphone based, titrated exercise solution for patients with Parkinson*s disease in daily life - pilot study

Exercise affords health benefits for patients with Parkinson*s disease (PD),
but implementing exercise in daily life remains challenging. We recently showed
that PD patients can adhere to a 6 month high-intensity exercise training
program on a stationary bicycle at home and found a higher aerobic capacity and
improved motor symptoms after the training program. However, such a training
program is not very scalable. We take an important step forward by developing
and studying an innovative and fully decentralized smartphone-based program to
increase long-term physical activity in patients with PD in daily life.

The aim of this pilot study is to investigate whether the developed smartphone
app can increase physical activity in PD patients for a short period of time
(one month). The secondary aim is to study the usability and enjoyment of the
app and the potential effects of an increase in physical activity on physical
fitness, motor- and non-motor functioning.

Pilot double-blind controlled intervention study.

Patients will be randomized into one of three groups. All groups will be
encouraged to increase their physical activity level, measured in step counts
on the patients* own smartphone with a different percentage: (a) an increase in
step count of 10% (active control group, N = 10), (b) in increase in step
count of 50% (experimental group 1, N = 10), or (c) an increase in step count
of 100% (experimental group 2, N = 10), compared to their baseline level.

The motivational application is non-invasive and the risks associated with
participation in this project is negligible. Patients with PD will use the
application at home for a time period of four weeks. The interventional groups
will be encouraged to become substantially more active (ie. Take 50% or 100%
more steps than at baseline) and one group will be encouraged to only slightly
increase their physical activity level (ie. Take 10% more steps than at
baseline). At baseline and after four weeks, PD patients will visit the Radboud
University Medical Centre for measurements and PD patients and their caregivers
will fill in a questionnaire and will be interviewed by telephone. This will
take approximately 3-4 hours. All tests will be performed in the medication on
state. Travel expenses will be reimbursed.