Feasibility and safety of a home-based physical therapy intervention to reverse frailty in patients with Parkinson’s disease: an exploratory pilot randomized clinical trial

Abstract The presence of frailty is common in people with Parkinson’s disease (PD), as is cognitive dysfunction. Frailty is a dynamic process that can be reversed, so early detection is essential. The objective of this study is to evaluate the feasibility and safety of a home-based physical therapy program for frail patients with idiopathic Parkinson’s disease and cognitive impairment. An exploratory, pilot, randomized, single-blind experimental study was conducted. Participants were recruited from a Home Rehabilitation Service. Safety was assessed by recording adverse events such as falls, motor deterioration, and treatment-related complications, while feasibility was determined by whether the intervention could be delivered as planned, taking into account resources, time, and patient acceptance. The intervention group completed a 16-session supervised home-based physiotherapy program over 8 weeks, whereas the control group maintained usual activities. Fifteen patients were recruited. The intervention demonstrated excellent feasibility, with a 100% session completion rate and no adverse events recorded. Exploratory analyses suggested potential benefits in frailty levels, functional performance, disease severity, and quality of life in the intervention group; however, these findings should be interpreted with caution given the pilot nature of the study and the small sample size. A multicomponent home physiotherapy program in frail patients with PD and cognitive impairment is safe and feasible, while reducing the level of frailty. In this patient profile, it is necessary to continuously assess frailty and cognitive impairment, and to implement tailored and prolonged intervention programs, with constant follow-up, to address functional difficulties that arise during the evolution of the disease. ClinicalTrials.gov ID: NCT05388526