Parkinson's disease (PD) often leads to multifactorial motor and non-motor disabilities with resultant social restrictions. Continuity of care in this pathology, including a tailored home rehabilitation, is crucial to improve or maintain the quality of life for patients. The aim of this multicenter study was to test in a pilot sample of PD patients the efficiency and efficacy of the Human Empowerment Aging and Disability (HEAD) program. The virtual reality HEAD program was administered in two consecutive phases: (1) in clinic (ClinicHEAD, 12 45-minutes sessions, 3 sessions/week); (2) at home (HomeHEAD, 60 45-minutes sessions, 5 sessions/week). Thirty-one PD outpatients were enrolled [mean age (SD) = 66.84 (9.13)]. All patients performed ClinicHEAD, and after allocation (ratio 1:2) were assigned to the HomeHEAD or the Usual Care (UC) group. Motor, cognitive and behavioral outcome measures were assessed at enrollment (T0), at hospital discharge (T1), at 4 (T2) and 7 (T3) months after baseline. After ClinicHEAD (T1 vs. T0 comparison) a significant (p < 0.05) improvement in functional mobility, balance, upper limb mobility, global cognitive function, memory, quality of life and psychological well-being was observed. After the HomeHEAD intervention there was an additional enhancement for upper limb mobility. At T3 follow-up, the UC group that did not continue the HEAD program at home showed a worsening with respect to the HomeHEAD group in balance and functional mobility. Furthermore, in the HomeHEAD group, a positive association was observed between adherence, mental and physical health (SF-12). A trend was also registered between adherence and positive affect. The digital health patient-tailored rehabilitation program resulted in improving motor and non-motor abilities and quality of life in clinical setting, enhancing the motor function in telerehabilitation at home, and maintaining the non-motor abilities and quality of life at follow-up. In the near future, people with PD can be supported also at home with individualized rehabilitation strategies for a better quality of life and wellbeing along with lower costs for society.

中文翻译：

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针对帕金森氏病患者的创新性远程康复干预对生活质量，运动能力和非运动能力的影响。

帕金森氏病（PD）通常导致多因素运动和非运动残疾，并因此而产生社会限制。在这种病理学中的连续护理，包括量身定制的家庭康复，对于改善或维持患者的生活质量至关重要。这项多中心研究的目的是在PD患者的先导样本中测试人类赋能老龄化和残疾（HEAD）计划的效率和功效。虚拟现实HEAD程序分为两个连续阶段进行管理：（1）在诊所（ClinicHEAD，12个45分钟疗程，每周3个疗程）；（2）在家（HomeHEAD，60个45分钟的课程，每周5个课程）。招募了31名PD门诊患者[平均年龄（SD）= 66.84（9.13）]。所有患者均接受ClinicHEAD治疗，分配后（比率1：2）被分配到HomeHEAD或常规护理（UC）组。在入组（T0），出院（T1），基线后4（T2）和7（T3）月评估运动，认知和行为结局指标。经过ClinicHEAD（T1与T0的比较）后，观察到功能性活动能力，平衡，上肢活动性，整体认知功能，记忆力，生活质量和心理健康水平显着（p <0.05）改善。在HomeHEAD干预之后，上肢的活动性有了进一步的增强。在T3随访中，未在家里继续执行HEAD计划的UC组相对于HomeHEAD组在平衡和功能移动性方面表现出了恶化。此外，在HomeHEAD组中，依从性，心理和身体健康（SF-12）之间存在正相关。在坚持和积极影响之间也有趋势。数字健康患者量身定制的康复计划可改善临床环境中的运动和非运动能力以及生活质量，增强在家进行远程康复时的运动功能，并在随访时保持非运动能力和生活质量。在不久的将来，PD患者也可以在家中得到个性化的康复策略的支持，以改善生活质量和福利，并降低社会成本。