{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:53:56Z","timestamp":1782978836952,"version":"3.54.5"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:00:00Z","timestamp":1568160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["F32HS025077"],"award-info":[{"award-number":["F32HS025077"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["H133P130013"],"award-info":[{"award-number":["H133P130013"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009713","name":"Foundation for Physical Therapy","doi-asserted-by":"publisher","award":["NIFTI2016\u20132018"],"award-info":[{"award-number":["NIFTI2016\u20132018"]}],"id":[{"id":"10.13039\/100009713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Northwestern University Clinical and Translational Science"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001422"],"award-info":[{"award-number":["UL1TR001422"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Purpose<\/jats:title>\n                  <jats:p>European clinical practice guidelines recommend physical therapy for people with Parkinson disease (PD) soon after diagnosis to provide education, physical activity advice, and individualized interventions when needed. However, therapy is frequently not used until after gait and balance problems occur. The purpose of this administrative case study is to present the application of a proactive physical therapy (PAPT) approach at 1 rehabilitation center using implementation frameworks to support the (1) implementation process, (2) determinants of implementation success, and (3) implementation evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case Description<\/jats:title>\n                  <jats:p>The PAPT program targeted people with PD before the onset of significant mobility dysfunction. It was initiated in 1 outpatient neurological rehabilitation center. The program used shared decision-making to promote long-term maintenance of independent exercise. The Knowledge-to-Action Framework was used by champions to plan implementation processes. Implementation barriers were addressed using the Consolidated Framework for Implementation Research. The program was evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework with mixed methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>In the program\u2019s first year, 38 people were referred, 28 were evaluated, and 20 participated in the 6-month program evaluation. Following PAPT, the number of participants reporting regular participation in aerobic, strengthening, and flexibility exercise approximately doubled, while those engaging in balance activities increased from 1 to 8. They reported a median of 140\u00a0minutes of aerobic exercise per week. Implementation barriers included location, insurance coverage, and difficulty scheduling long-term follow-up visits. Participants reported physical and emotional benefits of the program.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Implementation frameworks assisted with the implementation and evaluation of a PAPT delivery model that helped people with PD to increase and maintain independent exercise participation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzz129","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T11:42:32Z","timestamp":1567683752000},"page":"1644-1655","source":"Crossref","is-referenced-by-count":23,"title":["Using Implementation Frameworks to Provide Proactive Physical Therapy for People With Parkinson Disease: Case Report"],"prefix":"10.1093","volume":"99","author":[{"given":"Miriam R","family":"Rafferty","sequence":"first","affiliation":[{"name":"Shirley Ryan AbilityLab Illinois; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University , 355 E Erie St, 19th Floor Strength and Endurance Lab, Chicago, IL 60611 (USA); and Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab . Dr MacDonald is a board-certified clinical specialist in neurologic physical therapy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandria","family":"Byskosh","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sloan","sequence":"additional","affiliation":[{"name":"DPT Shirley Ryan AbilityLab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Toledo","sequence":"additional","affiliation":[{"name":"Shirley Ryan AbilityLab; and Department of Physical Medicine and Rehabilitation , Feinberg School of Medicine, Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Marciniak","sequence":"additional","affiliation":[{"name":"AbilityLab; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University ; and Department of Neurology, Feinberg School of Medicine, Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Simuni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Feinberg School of Medicine , Northwestern University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,11]]},"reference":[{"key":"2023011903540798200_ref1","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1002\/mds.22162","article-title":"Distribution of motor impairment influences quality of life in Parkinson's disease","volume":"23","author":"Stewart","year":"2008","journal-title":"Mov Disord."},{"key":"2023011903540798200_ref2","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1001\/archneurol.2009.221","article-title":"Clinical features in early Parkinson disease and survival","volume":"66","author":"Lo","year":"2009","journal-title":"Arch Neurol."},{"key":"2023011903540798200_ref3","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.2522\/ptj.20110472","article-title":"Exercise for people in early- or mid-stage Parkinson disease: a 16-month randomized controlled trial","volume":"92","author":"Schenkman","year":"2012","journal-title":"Phys Ther."},{"key":"2023011903540798200_ref4","doi-asserted-by":"crossref","first-page":"f576","DOI":"10.1136\/bmj.f576","article-title":"Promotion of physical activity and fitness in sedentary patients with Parkinson's disease: randomised controlled trial","volume":"346","author":"Nimwegen","year":"2013","journal-title":"BMJ."},{"key":"2023011903540798200_ref5","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/1545968314539732","article-title":"Two-year exercise program improves physical function in Parkinson's disease: the PRET-PD randomized clinical trial","volume":"29","author":"Prodoehl","year":"2015","journal-title":"Neurorehabil Neural Repair."},{"key":"2023011903540798200_ref6","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1212\/WNL.45.1.205","article-title":"Physical therapy in Parkinson's disease","volume":"45","author":"MacKay-Lyons","year":"1995","journal-title":"Neurology."},{"key":"2023011903540798200_ref7","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1212\/WNL.43.5.1056","article-title":"Treatment of Parkinson's disease","volume":"43","author":"McFarland","year":"1993","journal-title":"Neurology."},{"key":"2023011903540798200_ref8","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1093\/ptj\/80.6.578","article-title":"Movement disorders in people with Parkinson disease: a model for physical therapy","volume":"80","author":"Morris","year":"2000","journal-title":"Phys Ther."},{"key":"2023011903540798200_ref9","article-title":"on behalf of the Guideline Development Group. European physiotherapy guideline for Parkinson's disease","volume":"2014","author":"Keus","year":"15, 2015","journal-title":"The Netherlands: KNGF\/ParkinsonNet"},{"key":"2023011903540798200_ref10","first-page":"2017","article-title":"Non-pharmacological management of motor and non-motor symptoms. NICE Guideline: Parkinson's Disease in","author":"National Institute for Health and Care Excellence","year":"2017","journal-title":"Adults"},{"key":"2023011903540798200_ref11","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1212\/WNL.0000000000004355","article-title":"Utilization of rehabilitation therapy services in Parkinson disease in the United States","volume":"89","author":"Fullard","year":"2017","journal-title":"Neurology."},{"key":"2023011903540798200_ref12","article-title":"Physiotherapy for Parkinson's disease: a comparison of techniques","volume":"6","author":"Tomlinson","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"key":"2023011903540798200_ref13","article-title":"Physiotherapy versus placebo or no intervention in Parkinson's disease","volume":"9","author":"Tomlinson","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"key":"2023011903540798200_ref14","author":"Centers for Medicare and Medicaid Services","year":"5, 2016"},{"key":"2023011903540798200_ref15","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3233\/JPD-160912","article-title":"Regular exercise, quality of life, and mobility in Parkinson's disease: a longitudinal analysis of National Parkinson Foundation quality improvement initiative data","volume":"7","author":"Rafferty","year":"2017","journal-title":"J Parkinsons Dis."},{"key":"2023011903540798200_ref16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/1077558711430690","article-title":"A compilation of strategies for implementing clinical innovations in health and mental health","volume":"69","author":"Powell","year":"2012","journal-title":"Med Care Res Rev."},{"key":"2023011903540798200_ref17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13012-015-0242-0","article-title":"Making sense of implementation theories, models and frameworks","volume":"10","author":"Nilsen","year":"2015","journal-title":"Implement Sci."},{"key":"2023011903540798200_ref18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1002\/chp.47","article-title":"Lost in knowledge translation: time for a map?","volume":"26","author":"Graham","year":"2006","journal-title":"J Contin Educ Health Prof."},{"key":"2023011903540798200_ref19","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","year":"2009","journal-title":"Implement Sci."},{"key":"2023011903540798200_ref20","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.2105\/AJPH.2013.301299","article-title":"The RE-AIM framework: a systematic review of use over time","volume":"103","author":"Gaglio","year":"2013","journal-title":"Am J Public Health."},{"key":"2023011903540798200_ref21","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1212\/WNL.0000000000002670","article-title":"Quality improvement in neurology: Parkinson disease update quality measurement set: executive summary","volume":"86","author":"Factor","year":"2016","journal-title":"Neurology."},{"key":"2023011903540798200_ref22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/NPT.0b013e31829157c0","article-title":"Physical activity behavior change in persons with neurologic disorders: overview and examples from Parkinson disease and multiple sclerosis","volume":"37","author":"Ellis","year":"2013","journal-title":"J Neurol Phys Ther."},{"key":"2023011903540798200_ref23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/1471-2377-10-70","article-title":"Design and baseline characteristics of the ParkFit study, a randomized controlled trial evaluating the effectiveness of a multifaceted behavioral program to increase physical activity in Parkinson patients","volume":"10","author":"Nimwegen","year":"2010","journal-title":"BMC Neurol."},{"key":"2023011903540798200_ref24","article-title":"Accuracy of fall prediction in Parkinson disease: six-month and 12-month prospective analyses","volume":"2012","author":"Duncan","year":"2012","journal-title":"Parkinsons Dis."},{"key":"2023011903540798200_ref25","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform."},{"key":"2023011903540798200_ref26","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual Health Res."},{"key":"2023011903540798200_ref27","author":"Academy of Neurologic Physical Therapy"},{"key":"2023011903540798200_ref28","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.2522\/ptj.20120286","article-title":"Implementation of shared decision making in physical therapy: observed level of involvement and patient preference","volume":"93","author":"Dierckx","year":"2013","journal-title":"Phys Ther."},{"key":"2023011903540798200_ref29","doi-asserted-by":"crossref","first-page":"613","DOI":"10.2522\/ptj.20130434","article-title":"The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: administrative case report","volume":"95","author":"Schreiber","year":"2015","journal-title":"Phys Ther."},{"key":"2023011903540798200_ref30","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1186\/s12913-017-2795-x","article-title":"PROPEL: Implementation of an evidence based pelvic floor muscle training intervention for women with pelvic organ prolapse: a realist evaluation and outcomes study protocol","volume":"17","author":"Maxwell","year":"2017","journal-title":"BMC Health Serv Res."},{"key":"2023011903540798200_ref31","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s12883-017-0809-2","article-title":"Evaluation and implementation of highly challenging balance training in clinical practice for people with Parkinson's disease: protocol for the HiBalance effectiveness-implementation trial","volume":"17","author":"Leavy","year":"2017","journal-title":"BMC Neurol."},{"key":"2023011903540798200_ref32","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/S0277-9536(99)00145-8","article-title":"Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model","volume":"49","author":"Charles","year":"1999","journal-title":"Soc Sci Med."},{"key":"2023011903540798200_ref33","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/109019817400200403","article-title":"Historical origins of the health belief model","volume":"2","author":"Rosenstock","year":"1974","journal-title":"Health Educ Monogr."},{"key":"2023011903540798200_ref34","article-title":"Caring interactions in secondary prevention programs: a qualitative inquiry of individuals with Parkinson's disease","author":"Greviskes","year":"2018","journal-title":"J Geriatr Phys Ther."},{"key":"2023011903540798200_ref35","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/NPT.0b013e318254ba7a","article-title":"Capturing ambulatory activity decline in Parkinson's disease","volume":"36","author":"Cavanaugh","year":"2012","journal-title":"J Neurol Phys Ther."},{"key":"2023011903540798200_ref36","first-page":"1","article-title":"Physiotherapy and occupational therapy vs no therapy in mild to moderate Parkinson disease: a randomized clinical trial","author":"Clarke","year":"2016","journal-title":"JAMA Neurol."},{"key":"2023011903540798200_ref37","doi-asserted-by":"crossref","first-page":"S46","DOI":"10.1097\/NPT.0000000000000166","article-title":"From disease to health: physical therapy health promotion practices for secondary prevention in adult and Pediatric neurologic populations","volume":"41","author":"Quinn","year":"2017","journal-title":"J Neurol Phys Ther."},{"key":"2023011903540798200_ref38","volume-title":"Finding What Works in Health Care: Standards for Systematic Reviews","author":"Institute of Medicine","year":"2011"},{"key":"2023011903540798200_ref39","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1177\/1049731509335549","article-title":"Core implementation components","volume":"19","author":"Fixsen","year":"2009","journal-title":"Res Soc Work Pract."}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzz129\/29964594\/pzz129.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/99\/12\/1644\/48761324\/ptj_99_12_1644.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/99\/12\/1644\/48761324\/ptj_99_12_1644.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T03:57:41Z","timestamp":1674100661000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/99\/12\/1644\/5567235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,11]]},"references-count":39,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12,16]]}},"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzz129","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,12]]},"published":{"date-parts":[[2019,9,11]]}}}