2025 Theses Doctoral

Implementation of Consumer Wearable Devices as a Self-Management Tool in a Physical Activity Coaching Program for People with Early-Stage Parkinson’s Disease: A Mixed Methods Study

Pacheco, Alissa C.

Background.
Parkinson’s Disease (PD) is a progressive neurodegenerative disease that results in both motor and non-motor impairments. While physical activity (PA) engagement is crucial for managing symptoms and disease progression, inactivity is common, and many people do not meet the recommended levels of weekly PA. Consumer wearable devices (CWDs) can monitor PA in real time and may support self-management strategies for this population.

Introduction & Purpose.
This mixed methods study explored the implementation of CWDs within a 16-week PA behavior change coaching program for individuals in early-stage PD. The purpose of the study was to understand how PA patterns change during a PA behavior change intervention as tracked by CWDs, and to explore how people with PD (PwP) integrate these devices into their daily PA routines.

Methods.
Twenty-one participants in early-stage PD received six virtual occupational therapy sessions involving PA education, personalized goal setting, and guidance in using CWDs for PA tracking. Wear time was recorded in average minutes per day. Quantitative data from CWDs (step count and PA from heart rate (HR) intensity) were analyzed using linear mixed models (LMMs). Participants were categorized as exercisers or non-exercisers based on self-reported prior activity habits to assess group effects. Post-intervention questionnaires and interviews were analyzed using descriptive statistics and thematic analysis.

Results.
Participants demonstrated high wear time of their CWDs across the 16-week intervention. While LMMs revealed no significant changes in PA over time, non-exercisers spent significantly more time in the 60-70% and 70-85% HR range and had higher average step counts than exercisers, while exercisers spent significantly more time in the 80-85% HR range. Step count and HR tracking were the most used and valued device features. Five themes emerged from the qualitative data: (1) adapting to technology, (2) perceived importance of CWDs and self-monitoring, (3) role in behavior change, (4) integrating therapist guidance and support with CWDs, and (5) CWDs impact on the self-management of PwP.

Conclusions.
CWDs can be successfully implemented in remotely-delivered PA coaching programs for people in early-stage PD, and are both feasible and acceptable. Although no significant improvements in PA were observed, participants sustained levels of moderate-to-high intensity PA throughout the 16-week intervention. With structured support, CWDs may enhance self-efficacy, autonomy, and PA engagement in PwP. Clinicians should consider integrating CWDs into rehabilitation programs alongside personalized behavioral coaching, structured goal setting, and PA engagement. CWDs may be used as self-management tools to help PwP manage their PA routines and empower them to take an active role in managing their condition.