Tim Passmore, PhD 

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Investigator Bio:   

Dr. Tim Passmore is the Interim Chair of the School of Applied Health & Recreation at Oklahoma State University. He is also the Chair of the International Committee on Accreditation of Recreational Therapy Education (CARTE). Dr. Passmore has led the research agenda for Recreational Therapy at Oklahoma State University since 2005 and serves as the Chair of the Recreational Therapy Licensing Committee of the Oklahoma Medical Licensing Board. 

Objectives/Background:

Parkinson’s disease (PD) is a progressive neuro-degenerative disorder affecting over 10 million people worldwide, with rural communities facing the greatest challenges due to limited healthcare access. In Oklahoma, 34% of the population resides in rural areas – well above the national average – where specialized care is scarce and movement disorder specialists are nearly nonexistent. With approximately 11,300 Oklahomans diagnosed with PD, rural patients face heightened risks of mobility decline, social isolation, and hospitalization due to falls. Despite clear evidence that exercise improves PD outcomes, fewer than 30% of individuals with PD engage in regular physical activity. 

This research aims to create a scalable, evidence-based home exercise manual for PD care, empowering patients to maintain mobility, prevent falls, and improve independence. 

Methods/Design:

This study follows a six-month hybrid intervention model. In the first three months, participants will engage in supervised community-based exercise focusing on Tai Chi (neuromuscular control), recreational boxing (strength and coordination), and progressive balance training (postural stability). The second phase transitions participants to a home-based program using the developed manual and videos, with weekly remote coaching for guidance and motivation. Thirty PD patients aged 55-80 from rural Oklahoma will be randomly assigned to either the intervention group (structured home exercise program) or the control group (general post-program monitoring). Outcomes will be assessed at baseline, three months, and six months using: 

• Hospital Anxiety and Depression Scale (HADS): Measures changes in anxiety and depression. 

• Lubben Social Network Scale (LSNS-6): Assesses social connectedness and perceived support. 

• Parkinson’s Disease Questionnaire-39 (PDQ-39): Evaluates disease-specific questions. 

Relevance to Diagnosis/Treatment of Parkinson’s Disease:

Exercise is one of the most effective non-pharmacological interventions for improving motor function, balance, and quality of life in PD, yet adherence remains critically low – particularly among individuals in rural settings, where structured programs are often unavailable. This study addresses this gap by developing and evaluating a structured home exercise program incorporating evidence-based movement therapies (Tai Chi, recreational boxing, and balance training). The intervention will be delivered through a structured manual, instructional videos, and weekly remote coaching, providing a scalable and cost-effective solution for long-term PD management.