Online dance versus online therapeutic exercise on quality of life - a study protocol for a randomized controlled trial investigating social telerehabilitation efficacy in Parkinson disease

Social telerehabilitation delivers rehabilitation services over online video conferencing within a social context. The modality of multimodal therapeutic exercises is the most recommended rehabilitation for individuals with PD, although other modalities, such as dance, have shown potential benefits. The investigation of the feasibility and efficacy of these therapeutic strategies in a remote online format is unknown. This is a prospectively registered two-arm randomised controlled trial investigating the efficacy of online dance compared to online multimodal therapeutic exercise by looking at the biopsychosocial PD aspects. Individuals diagnosed with idiopathic PD between 40 and 90 years old, at any stage of disease severity, and without cognitive impairment will be recruited from the community. Participants will be randomly allocated to one of the two social telerehabilitation groups: (1) dance and music or (2) multimodal therapeutic exercise and music. Interventions will occur twice a week for twelve weeks. Each session will last 60 min. Tele-assessments will be conducted pre-, post-, and one-month follow-up through a videoconference platform. For feasibility, primary outcomes will include adherence, attendance, adverse events, and participants’ perceptions of enjoyment and socialisation. For efficacy, primary outcomes will investigate well-being by positive affect (by the Positive Affect and Negative Affect Schedule) and persistent anxiety, episodic anxiety, and avoidance behaviour (by the Parkinson Anxiety Scale). Secondary outcomes will include motor severity (by the UPDRS III), functional lower extremity strength (by the Five Times Sit to Stand Test), memory and attention (by the Attention and Recognition Memory Test), and quality of life (by the Parkinson’s Disease Questionnaire 39). We hypothesise that both interventions would effectively ameliorate motor symptoms. However, we expect dance to be more enjoyable and improve well-being by increasing positive affect and reducing anxiety signs.