R01HD110668

Consultative Physical Therapy: A Physical Activity and Exercise Implementation Strategy in Parkinson's - Project Summary/Abstract:

Exercise is a subset of physical activity that is structured and planned, with a goal to increase fitness. Regular exercise is associated with slower declines in Parkinson’s-related mobility outcomes and quality of life. However, fewer than half of people with Parkinson’s disease (PWP) achieve recommended levels of exercise.

Exercise barriers include low knowledge and expectations of the benefits, mobility concerns, and lack of time or convenient exercise options. Research is needed to determine how to facilitate exercise initiation, progression, and maintenance in PWP and those with other disabilities or chronic conditions.

Physical therapy (PT) is a healthcare service that can help PWP and other conditions to address personal and environmental barriers to exercise. We have successfully piloted a consultative PT program to help PWP to increase and maintain their exercise and physical function. We distinguish consultative PT from traditional PT by using fewer, less frequent visits. Additionally, consultative PT focuses on exercise promotion in the presence of minimal or stable functional deficits, rather than brief but intense episodes of PT for functional gains.

However, referral to consultative PT challenges traditional perceptions of PT as a treatment for mobility problems. The proposed effectiveness-implementation hybrid type II study will systematically evaluate consultative PT in two dissimilar contexts to inform effective sustainment, equitable spread to other Parkinson’s programs, and future scaling to other populations that can benefit from exercise monitoring and maintenance.

First, we will use mixed effects regression models to evaluate differences in 12-month physical activity trajectories between individuals enrolled during periods of (1) standard care, (2) written exercise guidance from neurologists, and (3) consultative PT (AIM1). We will enroll 96 PWP per group. We hypothesize that consultative PT will help PWP improve and maintain exercise participation, controlling for disease-specific factors and social determinants of health.

Second, we will contrast consultative PT implementation determinants, strategies, outcomes, and sustainment between organizations in two dissimilar communities (AIM 2). We will study determinants at the individual, interpersonal, organizational, and community levels. We hypothesize that facilitated implementation will lead to similar fidelity, adoption, acceptability, and appropriateness between organizations, but that the lower-resourced community will experience challenges to reach and sustainment.

This proposal is responsive to the National Institutes of Health Notice of Special Interest on developing and testing multilevel physical activity interventions (NOT-OD-21-087). Additionally, the proposed project addresses the Eunice Kennedy Shriver National Institute on Child Health and Human Development’s research theme to advance safe and effective therapeutic interventions for people with disabilities. Targeting two dissimilar communities will facilitate the equity of the current and future work to help us optimize abilities for all.

Rehabilitation Institute Of Chicago

TO CONDUCT AND SUPPORT LABORATORY RESEARCH, CLINICAL TRIALS, AND STUDIES WITH PEOPLE THAT EXPLORE HEALTH PROCESSES. NICHD RESEARCHERS EXAMINE GROWTH AND DEVELOPMENT, BIOLOGIC AND REPRODUCTIVE FUNCTIONS, BEHAVIOR PATTERNS, AND POPULATION DYNAMICS TO PROTECT AND MAINTAIN THE HEALTH OF ALL PEOPLE. TO EXAMINE THE IMPACT OF DISABILITIES, DISEASES, AND DEFECTS ON THE LIVES OF INDIVIDUALS. WITH THIS INFORMATION, THE NICHD HOPES TO RESTORE, INCREASE, AND MAXIMIZE THE CAPABILITIES OF PEOPLE AFFECTED BY DISEASE AND INJURY. TO SPONSOR TRAINING PROGRAMS FOR SCIENTISTS, DOCTORS, AND RESEARCHERS TO ENSURE THAT NICHD RESEARCH CAN CONTINUE. BY TRAINING THESE PROFESSIONALS IN THE LATEST RESEARCH METHODS AND TECHNOLOGIES, THE NICHD WILL BE ABLE TO CONDUCT ITS RESEARCH AND MAKE HEALTH RESEARCH PROGRESS UNTIL ALL CHILDREN, ADULTS, FAMILIES, AND POPULATIONS ENJOY GOOD HEALTH. THE MISSION OF THE NICHD IS TO ENSURE THAT EVERY PERSON IS BORN HEALTHY AND WANTED, THAT WOMEN SUFFER NO HARMFUL EFFECTS FROM REPRODUCTIVE PROCESSES, AND THAT ALL CHILDREN HAVE THE CHANCE TO ACHIEVE THEIR FULL POTENTIAL FOR HEALTHY AND PRODUCTIVE LIVES, FREE FROM DISEASE OR DISABILITY, AND TO ENSURE THE HEALTH, PRODUCTIVITY, INDEPENDENCE, AND WELL-BEING OF ALL PEOPLE THROUGH OPTIMAL REHABILITATION.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

Chicago, Illinois 606113167 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the total obligations have increased 197% from $472,384 to $1,404,802.