Online group exercise for people with Parkinson’s disease: rehabilitation and fitness professionals’ experiences to inform physiotherapy practice and service delivery – a qualitative interview study

Background Online group exercise for people with Parkinson’s disease (PwP) has shown good feasibility, adherence, and health benefits. However, the rapid shift to online formats has raised concerns regarding the quality, content, and accessibility of these programs, especially for PwP. Little is known about how rehabilitation and fitness professionals deliver online group exercise for PwP and their experiences of doing it.Objective To explore current practices and challenge standards for delivery through exploring experiences of those delivering online exercise groups for PwP.Methods This study utilized a qualitative design, using thematic analysis with an inductive and deductive approach. In-depth, individual, semi-structured interviews were held with 10 rehabilitation and fitness professionals.Results Four overarching themes were identified: “Parkinson’s specific knowledge for class design” which included concerns of managing participant safety and the skills and experiences instructors need; “Pathway and referral flow” including concepts of working with other health and social care providers and referrals between service providers; “Parkinson’s stage-specific exercise prescription” incorporating difficulties with prescription of exercise to stages of Parkinson’s; and “Sustainable delivery models” that related to class aims, and sustainability and funding of businesses providing online group exercise for PwP.Conclusion Online exercise groups offer valuable support for PwP but face challenges in safety for those with complex symptoms, individualization, and integration into care pathways. Collaboration across sectors including health services, private providers, and charities alongside sustainable funding models are essential to optimize their role in long-term Parkinson’s care.