# Walking and mHealth to Increase Participation in Parkinson Disease (WHIP-PD)

> **NIH NIH R01** · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · 2021 · $612,272

## Abstract

PROJECT SUMMARY
Parkinson disease (PD) is one of the most disabling chronic health conditions affecting older adults globally.
While advances in medical and surgical management of PD have increased lifespans, they have not effectively
altered the progressive decline in physical function and quality of life associated with PD. Identifying effective
ways to improve function, slow decline and prevent or reduce disability remains of utmost importance in PD.
Of particular concern in PD is gait decline, which is considered a red flag signaling emerging disability. Our
prior work showed that people with PD experienced a 12% decline in amount of walking over one year –
despite relative stability of motor impairments during that year. Treatment targeting walking, the most rapidly
changing aspect of disability in PD, may have the greatest influence on slowing the impact of disease
progression on physical function and reducing disability.
Traditionally, rehabilitation has targeted impairments and functional limitations with the expectation that gains
would translate into greater participation in real-world activities. However, the evidence suggests that this does
not occur. In this proposal, we suggest a paradigm shift in which the primary target of the intervention is real-
world walking behavior, as greater walking activity could preserve walking function and slow disability. The
primary factors that limit engagement in walking in PD are psychological (e.g., low self-efficacy) rather than
physical (e.g., motor impairments) in nature. As such we will evaluate a cognitive-behavioral approach,
grounded in social-cognitive theory and targeted at enhancing walking activity. Our “connected behavioral
approach” links physical therapists to persons with PD using a mobile health (mHealth) platform to deliver
strategies to increase self-efficacy and provide goal-oriented, dynamic walking routines and walking enhancing
exercises over one year. We will compare this approach to a control intervention which provides equivalent
components and dosing of walking and a walking enhancing exercise program delivered by physical therapists
but without a cognitive-behavioral mHealth approach. We hypothesize that the mHealth group will
demonstrate higher amounts of walking activity and greater walking capacity relative to the control group. With
regard to mechanism underlying improvements in the mHealth group, we hypothesize that self-efficacy will
mediate changes in amount of walking and that changes in amount of walking will mediate changes in walking
capacity over one year. The insights to be gained regarding mechanisms underlying changes noted will be
critical to inform rehabilitation interventions designed to encourage sustained, long-term physical activity. If
effective, our “connected behavioral approach” offers a unique, generalizable and scalable means to increase
walking activity and improve walking capacity, thereby reducing disability in PD and perhaps in other chron...

## Key facts

- **NIH application ID:** 10141280
- **Project number:** 5R01HD092444-04
- **Recipient organization:** BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
- **Principal Investigator:** GAMMON M. EARHART
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $612,272
- **Award type:** 5
- **Project period:** 2018-06-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10141280

## Citation

> US National Institutes of Health, RePORTER application 10141280, Walking and mHealth to Increase Participation in Parkinson Disease (WHIP-PD) (5R01HD092444-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10141280. Licensed CC0.

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