BACKGROUND AND PURPOSE: Physical activity has beneficial symptomatic effects for people with Parkinson's disease (PD), but increasing-and sustaining-a physically active lifestyle remains challenging. We investigated the feasibility (ability to increase step counts) and usability of a behavioral intervention using a motivational smartphone application to remotely increase physical activity in PD. METHODS: We performed a 4-week, double-blind pilot trial. Thirty people with PD who were able to walk independently and did not take more than 7000 steps at baseline were randomized to minimal, moderate, or large increases in step counts. Step counts were continuously collected with the participants' own smartphones. Usability was assessed with a translated version of the System Usability Scale. We reported the distribution of clinical characteristics in our participants. RESULTS: Step counts per day increased over 4 weeks in a dose-dependent pattern (mean +/- standard deviation: minimal 1064 +/- 1030, moderate 1689 +/- 2060, large 2745 +/- 3817). The usability of the STEPWISE app (System Usability Scale) was perceived as excellent (mean +/- standard deviation: 86.6 +/- 12.7). DISCUSSION AND CONCLUSIONS: Our findings support the notion that a titrated increase in daily step count is feasible over 4 weeks. This motivates and supports further development of a smartphone application to increase physical activity in people with manifest PD. If effective, this behavioral intervention could provide an accessible option for people with PD worldwide.

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