Implementation of highly challenging balance training for Parkinson’s disease in clinical practice : a process evaluation
Date
2021-02-01
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Process evaluations provide contextual insight into the way in which interventions are delivered. This
information is essential when designing strategies to implement programs into wider clinical practice. We
performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly
challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to
investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation.
Methods: Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation
of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program
delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was
mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase.
Results: Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions.
Trainer fidelity to program core components was very high in 104 (87%) of the sessions. Participant responsiveness
to the core components was generally high, although adherence to the home exercise program was low (50%). No
significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or
participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity,
high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent
reactional balance among participants, as well a heterogeneous group in relation to balance capacity.
Conclusion: These findings provide corroborating evidence for outcome evaluation results and valuable
information for the further adaptation and implementation of this program. Important lessons can also be learned
for researchers and clinicians planning to implement challenging exercise training programs for people with mildmoderate
PD.
Description
CITATION: Leavy, B., et al. 2021. Implementation of highly challenging balance training for Parkinson’s disease in clinical practice : a process evaluation. BMC Geriatrics, 21:96, doi:10.1186/s12877-021-02031-1.
The original publication is available at https://bmcgeriatr.biomedcentral.com
The original publication is available at https://bmcgeriatr.biomedcentral.com
Keywords
Parsinson's disease -- Exercise therapy -- Evaluation, Equilabrium (Physiology), Parkinson's disease -- Patients -- Rehabilitation
Citation
Leavy, B., et al. 2021. Implementation of highly challenging balance training for Parkinson’s disease in clinical practice : a process evaluation. BMC Geriatrics, 21:96, doi:10.1186/s12877-021-02031-1