The development of a complex intervention to support exercise self-management for people with Parkinson's

Keywords: Parkinson's; Self-management; Exercise Purpose: The value of exercise for people with Parkinson's (PwP) is undisputed, and associated improved health outcomes potential to slow down the rate symptom decline. However, optimum means support long-term participation in remains undetermined. Current provision within physiotherapy commonly time limited. Moreover, research has shown that when current services cease, adherence declines effects on diminish. Therefore, a sustainable maintaining activity, beyond end normal care, required, which necessitates different approach People PwP be more active. Aims: To develop an evidence based intervention equip self-manage their participation. Methods: A multi-step mixed methods was adopted. systematic review literature exploring barriers motivators comprehensive conducted. Consultation convenience sample drawn from UK wide specialist physiotherapists community conducted explore facilitators delivery findings were used inform development multi-component aimed at promoting self-management. involved refining intervention. Results: identified simply prescribing isolation ineffective promote changes behaviour. Amalgamating reviews consultation finding key ingredients self-management identified. These included: individualised programmes, contextualised education, strategies habit. While benefits widely acknowledged, need self-confidence, empower knowledge skills they embed everyday routine. Access professionals training highly valued, either 1:1 basis or group. interventions thought confidence, whereas group-based provided opportunity shared learning social network. Transport costs reported as barriers; accessibility sustainability This process informed PDConnect programme. evidence-informed underpinned by empowerment theory, aim providing toolkit behaviour change techniques combines physiotherapy, support, education threaded throughout. programme consists three components: (i) six sessions 1-1-specialist delivered home; (ii) 12 exercise, once week weeks; (iii) weeks self-management, session each month. Conclusion(s): Aligning Medical Research Council guidelines developing complex interventions, feasibility acceptability currently being tested evaluated those delivering receiving Impact: Promoting beneficial NHS reduce service utilisation prevent secondary complications related sedentary Funding acknowledgements: not funded. work jointly funded Chief Scientist Office, Scotland.