Pilot randomized controlled trial of the ReFresh online fatigue management programme for people with Parkinson’s disease

Fatigue is one of the most disabling symptoms experienced by people with Parkinson’s disease, yet few evidence-based non-pharmacological interventions are available. This study evaluated the feasibility, acceptability, and exploratory clinical signals of the Rebalancing Fatigue and Enhancing Self-Help (ReFresh) online fatigue management programme for people with Parkinson’s disease.
A pilot randomized controlled trial with a wait-list control group was conducted. Participants with Parkinson’s disease experiencing fatigue were randomized to either the six-week ReFresh online programme or a wait-list control. Feasibility outcomes included recruitment, retention, adherence, and participant engagement. Secondary outcomes included fatigue severity, fatigue self-efficacy, sleep quality, mood, and occupational performance.
A total of 118 participants were randomized. Recruitment targets were achieved; however, retention and adherence were modest. Participants who completed the programme reported improvements in fatigue self-efficacy and perceived ability to manage fatigue, while changes in fatigue severity were smaller. Qualitative feedback indicated that participants valued the flexibility and accessibility of the online format.
The ReFresh programme demonstrated feasibility and acceptability as a digitally delivered fatigue management intervention for people with Parkinson’s disease. Future research should explore strategies to improve engagement and evaluate the programme in a fully powered randomized controlled trial.
ISRCTN Registry, ISRCTN62114944, https://www.isrctn.com/ISRCTN62114944.
Fatigue is one of the most common and disabling symptoms experienced by people with Parkinson’s disease. It can affect daily activities, concentration, and overall quality of life. Despite its impact, few treatments specifically address fatigue in Parkinson’s disease.
The Rebalancing Fatigue and Enhancing Self-Help (ReFresh) programme was developed to help people with Parkinson’s disease better understand and manage fatigue. The programme was adapted from an existing fatigue management programme originally designed for people with multiple sclerosis. ReFresh was delivered online over six weeks and included educational modules, practical strategies, and reflective activities aimed at helping participants manage energy levels and daily routines.
In this study, people with Parkinson’s disease who experienced fatigue were randomly assigned either to take part in the ReFresh programme or to a wait-list control group. The main aim was to examine whether the programme was feasible and acceptable, and whether it showed early signs of benefit.
A total of 118 participants took part in the trial. Recruitment was successful, but some participants did not complete all modules of the programme. Participants who completed the programme reported improved confidence in their ability to manage fatigue and found the online format convenient and accessible.
These findings suggest that ReFresh may be a promising approach for supporting fatigue management in Parkinson’s disease. However, further research is needed to improve participant engagement and to test the programme in a larger trial.