Post-rehabilitation self-management support on physical activity and nutrition, including mHealth, improves physical capacity, physical activity, and health related quality of life in people with Parkinson's- results from a randomised controlled trial.

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BACKGROUND: Maintaining long-term engagement in physical activity (PA) and following nutrition recommendations after rehabilitation is challenging for people with Parkinson’s. Sustained behavioural change requires more than initial education; person-centred, self-management support may be key to maintain health-promoting routines. However, structured follow-up is often lacking. Digital health interventions, including mobile health (mHealth), offer scalable solutions to provide ongoing support beyond rehabilitation. This study aimed to examine the effect of an individualised, mHealth support programme targeting self-management of PA, and nutrition on physical capacity, nutritional status, HRQOL, Physical function and engagement in PA in people with Parkinson’s. METHODS: A single-blind, two-arm randomised controlled trial evaluating the effects of a six-month individualised mHealth self-management support programme on physical capacity and related outcomes in people with Parkinson’s following inpatient interdisciplinary rehabilitation. Participants were randomly assigned (1:1) to an intervention group (mHealth); monthly remote consultations plus activity tracker, or a control group; usual care. The primary outcome was physical capacity (6MWT). Secondary outcomes were nutritional status (PG-SGA SF), Health Related Quality of Life (PDQ-39), physical function and engagement in PA (self-reported PA and activity tracker data). Linear mixed models for repeated measures were used to assess group differences over time. RESULTS: A total of 100 participants (40% female, mean age 67,5 years) were randomised (50 per group). At six months we observed significant between-group differences on 6MWT in favour of the intervention group (mean: 33.1 m; 95% CI: 14.8 to 51.3; p < 0.001; effects size = 0.75). Significant between-group differences were also observed in PDQ-39 SI(mean: -6.1; 95% CI: -9.5 to -2.8; p < 0.001; effect size 0.93) and in physical activity frequency (p = 0.02; effect size = 0.51). Additionally, the mHealth group significantly increased their daily steps (p = 0.006) and weekly intensity minutes (p = 0.042). No significant differences were found for nutritional status, or physical function. CONCLUSIONS: The six-month mHealth self-management support programme improved physical capacity, Health Related Quality of Life, and physical activity in people with Parkinson’s post-rehabilitation. These findings highlight the potential of scalable, person-centred digital self-management support interventions to sustain health-promoting behaviours beyond clinical settings. TRIAL REGISTRATION: The study was registered on ClinicalTrials under the code NCT04945876: https://clinicaltrials.gov/expert-search?term=NCT04945876 . First registration March 1, 2021.

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