A 12-WEEK teleneurorehabilitation programme incorporating physiotherapy, aerobic, and breathing exercises via mobile video calling significantly improved disease metric scores in patients with mild to moderate Parkinson’s disease and was as safe as in-person rehabilitation.
The TELEPARK randomised clinical trial aimed to assess the efficacy and safety of teleneurorehabilitation (TNR) in patients with Parkinson’s disease (PD) in low- and middle-income countries during the COVID-19 pandemic lockdown. Conducted over 11 months from September 2020 to July 2021, the trial included 63 participants diagnosed with idiopathic PD at Hoehn and Yahr stage 1 to 2.5, with a Mini-Mental State Examination score of 24 or higher. Participants, aged 18 years or older, were randomised into two groups: in-person rehabilitation or TNR therapy. The study sought to evaluate changes in motor and nonmotor symptoms and overall quality of life following the intervention.
Participants in the in-person group attended weekly 30-minute sessions for four weeks, followed by biweekly sessions for eight weeks. The TNR group had one initial in-person session, with subsequent supervised sessions via mobile video calls on a similar schedule. The primary outcome measure was the mean change in the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) scores from baseline to post-intervention. Additional assessments included changes in MDS-UPDRS II, Non-Motor Symptom Scale (NMSS), Parkinson’s Disease Questionnaire-8 Summary Index (PDQ8-SI), six-minute walk test (6MWT), and functional reach test (FRT) scores. Results demonstrated a significant reduction in MDS-UPDRS III scores following TNR (pre-TNR: 35.17 [17.72] vs post-TNR: 28.6 [19.7]; P = .001). The mean postintervention changes in MDS-UPDRS III scores did not significantly differ between the TNR (-6.74 [11.07]) and in-person (-7.54 [10.52]) groups (P = .39). Median changes in NMSS and PDQ8-SI scores were also comparable between groups, reinforcing the efficacy and safety of TNR.
These findings highlight the potential for TNR to serve as an effective alternative to traditional in-person rehabilitation, particularly in resource-limited settings. The study supports the integration of telemedicine into routine clinical practice for Parkinson’s disease management, offering a safe and accessible option for patients with mobility challenges or geographical barriers. Future research should explore long-term outcomes and scalability of TNR to enhance its implementation in broader healthcare frameworks.
Katrina Thornber, EMJ
Reference
Dhamija RK et al. Teleneurorehabilitation and motor and nonmotor symptoms and quality of life in parkinson disease: the TELEPARK randomized clinical trial. JAMA Neurol. 2025. DOI:10.1001/jamaneurol.2024.5387.
