{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:01:35Z","timestamp":1790650895707,"version":"4.1.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"Importance<\/jats:title>To our knowledge, no randomized clinical trials have compared the efficacy and safety of teleneurorehabilitation (TNR) with in-person rehabilitation in Parkinson disease (PD) during the COVID-19 pandemic lockdown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess the efficacy and safety of TNR among patients with PD during the COVID-19 lockdown.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>The TELEPARK single-center, assessor-blinded, randomized clinical trial was conducted over 11 months from September 2020 to July 2021, with follow-up after 12 weeks. Final data could be analyzed on July 1, 2024. Patients aged 18 years or older diagnosed with idiopathic PD with Hoehn and Yahr stage 1 to 2.5, Mini-Mental State Examination score of 24 or higher, and who possessed a smartphone allowing videocalling were eligible for inclusion and randomized to in-person or TNR therapy.<\/jats:p><\/jats:sec>Intervention<\/jats:title>The in-person group received physiotherapy, aerobic, and breathing exercises for 30 minutes in person once a week for 4 weeks and then once every 2 weeks for 8 weeks. The TNR group received in-person sessions on day 1, followed by supervised sessions via videocalling once a week for the first 4 weeks, then once every 2 weeks for 8 weeks.<\/jats:p><\/jats:sec>Main Outcome and Measures<\/jats:title>The primary outcome was mean change in the Movement Disorder Society\u2013Unified Parkinson\u2019s Disease Rating Scale III (MDS-UPDRS III) postintervention score from baseline. Mean changes in postintervention MDS-UPDRS II and III, Non-Motor Symptom Scale (NMSS), Parkinson\u2019s Disease Questionnaire-8 Summary Index (PDQ8-SI), 6-minute walk test (6MWT), and functional reach test (FRT) scores from baseline between groups was assessed using unpaired t<\/jats:italic> tests.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 63 participants (28 in-person and 35 TNR) were analyzed. Mean (SD) ages in the in-person and TNR groups were 60.50 (7.08) years and 62.80 (12.46) years, respectively. Twelve of 28 patients in the in-person group (42.9%) and 16 of 35 patients in the TNR group (45.7%) were female. Mean (SD) MDS-UPDRS III scores were significantly lower following TNR (pre-TNR: 35.17 [17.72] vs post-TNR: 28.6 [19.7]; P<\/jats:italic>\u2009=\u2009.001). Mean (SD) change in postintervention MDS-UPDRS III scores was not significantly different between the 2 groups (TNR: \u22126.74 [11.07] vs in-person: \u22127.54 [10.52]; P<\/jats:italic>\u2009=\u2009.39). Median changes in NMSS and PDQ8-SI scores were similar between the groups.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>TNR is safe and effective in improving motor and nonmotor symptoms and quality of life among Indian patients with PD.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaneurol.2024.5387","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T16:35:14Z","timestamp":1740414914000},"page":"376","source":"Crossref","is-referenced-by-count":10,"title":["Teleneurorehabilitation and Motor and Nonmotor Symptoms and Quality of Life in Parkinson Disease"],"prefix":"10.1001","volume":"82","author":[{"given":"Rajinder K.","family":"Dhamija","sequence":"first","affiliation":[{"name":"Department of Neurology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India"},{"name":"Now with Institute of Human Behaviour and Allied Sciences, New Delhi, 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