Key components for assessing and promoting safer mobility behaviour in Parkinson’s disease: A modified Delphi study

Introduction

Promoting safer mobility behaviour is an emerging concept that has been suggested as a common-sense approach to fall prevention in people with Parkinson’s disease (PwPD). Despite its potential, there is currently no assessment tool, nor optimal intervention addressing safer mobility behaviour for PwPD. This study aimed to develop a consensus on the key components that should be included in an assessment and intervention targeting safer mobility behaviour in PwPD.

Methods

A modified Delphi study was conducted over three rounds with two expert panels: (1) people with lived experience (PwPD and their support people) and (2) clinicians/researchers (physiotherapists, occupational therapists, and researchers). Round one involved using semi-structured interviews and focus groups to generate a list of assessment and intervention components. These components were then rated and ranked based on relative importance in two subsequent survey rounds. Feedback was provided, along with the chance to re-rate components that had not reached 80% consensus in the last survey round.

Results

Sixty lived experience and 43 clinician/researcher experts participated. Thirteen core components for assessment and intervention were identified, along with three assessment methods, support person involvement and use of technology. Consensus was reached for including all components and support person involvement, while use of technology did not reach consensus. Both panels ranked physical and functional cognitive ability as the top two components to include in an assessment. Participants emphasised using a combination of subjective and objective methods for assessment. Both panels ranked exercise, movement strategy training, and cognitive strategy training as the top three components to include in an intervention. Tailoring these components based on disease severity and Parkinson’s specific impairments was recommended.

Conclusion

This study provides the foundation for the key components that should be included in the future development of assessments and interventions targeting safer mobility behaviour in PwPD.