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mHealth-assisted expiratory muscle strength training in Parkinson's disease patients: A proof-of-concept study
M. Srp, ÁS. Ferro, J. Ferreira, R. Cacho, L. Antunes, R. Bouça-Machado, O. Gál, M. Hoskovcová, R. Kliment, J. Mužík, TA. Mestre, DP. Rangel, E. Růžička, IP. Consortium
Language English Country United States
Document type Journal Article, Multicenter Study
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- MeSH
- Patient Compliance * MeSH
- Breathing Exercises methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Mobile Applications * MeSH
- Resistance Training methods MeSH
- Proof of Concept Study * MeSH
- Parkinson Disease * rehabilitation physiopathology therapy MeSH
- Self Efficacy MeSH
- Aged MeSH
- Muscle Strength physiology MeSH
- Telemedicine * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
BACKGROUND: Expiratory muscle strength training (EMST) is acknowledged for its therapeutic benefits in Parkinson's disease (PD), yet long-term adherence remains a challenge. OBJECTIVE: The primary aim of this study was to assess the preliminary effects of EMST coupled with a mobile health app (SpiroGym) on self-efficacy and exercise adherence in PD patients. The secondary aim was to assess the usability of the SpiroGym app. METHODS: This single-group, multicenter, multinational proof-of-concept study involved 63 PD patients across four tertiary PD centers. Participants were enrolled in either a 1-week (n = 35) or 24-week (n = 28) EMST program coupled with SpiroGym app. Self-efficacy was assessed using the Self-Efficacy for Home Exercise Program scale (SEHEPS) and exercise adherence was monitored by SpiroGym app. Usability was evaluated using the System Usability Scale. RESULTS: Post-intervention, significant improvements in SEHEPS were observed in 1-week group (d = 0.48; p = 0.02) and 24-week group (d = 0.57; p = 0.002). Adherence rates in the 24-week PD patient group were high throughout the course of the study. Post-training SEHEPS was found to correlate (rho = 0.55; adjusted p = 0.016) with adherence to EMST during the non-supervised maintenance phase. The SpiroGym app exhibited high usability (>85th percentile score), with no significant differences noted between short-term and long-term use, indicating sustained user satisfaction. CONCLUSIONS: The results of our study suggest a promising role for SpiroGym app in supporting adherence to home-based EMST in PD patients. Nevertheless, future comparative studies are required to confirm SpiroGym's effectiveness.
CNS Campus Neurológico Torres Vedras Portugal
Faculty of Biomedical Engineering Czech Technical University Prague Czech Republic
HM CINAC Hospital Universitario HM Puerta del Sur Universidad CEU San Pablo Madrid Spain
Movement Disorders Unit Neurology Department Hospital Universitario 12 de Octubre Madrid Spain
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