Assessing the feasibility of Behavioural Activation (BAPP-VR) to support people with Parkinson’s Disease enhanced by a virtual reality exercise programme

This included a scoping review, Patient and Public involvement (PPI), an iterative process of each of the phases of BAPP-VR, as well as testing and feedback. The BAPP-VR intervention involved six group-based sessions, including one hour BA talking therapy, and a thirty-minute to one-hour virtual reality exercise programme. An introductory session was provided prior to the intervention at the hospice outpatient clinic. <br><br>Feasibility Study:<br>A mixed-methods, pre–post feasibility design was used to evaluate the feasibility of the BAPP-VR intervention within an outpatient unit at Marie Curie Hospice, Belfast in Northern Ireland.

The target sample was 18-24 people with Parkinson’s using purposive and convenience sampling, to be allocated to three separate consecutively run groups of BAPP-VR over three time periods from May to October 2023. Purposive sampling was used to recruit family members, carers, and healthcare professionals. Validated outcome measures were used to screen for inclusion and pre and post test data.

These included, Hoehn and Yahr scale (describes symptom progression), Berg Balance Scale (to determine balance ability), PHQ-9 (measures depression) and GAD-7 (measures severity of anxiety). The feasibility and acceptability of the study was determined using questionnaires and semi-structured interviews with 13 patients, 7 family members/carers and 3 healthcare staff who were directly involved in the intervention. <br><br>Results:<br>Thirteen participants were recruited to the BAPP-VR study.

Recruitment was a challenge due to the geographical location of the clinic for some people who lived too far away, and medication changes which were not permitted based on rigid inclusion and exclusion criteria. The total attrition rate for the study was zero. Findings indicate some improvement in depression scores.

However, these were not statistically significant, and improvements are preliminary. These indicate trends rather than definitive effects. <br><br>Conclusion:<br>BAPP-VR for people with Parkinson’s is broadly acceptable for patients, carers and healthcare staff, with some promising improvements in depression and balance. A larger trial would be feasible with some adjustments to the protocol.