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| Theme 1: suitability and choice of actions |
| The interviews revealed mixed experiences of the actions practiced within the training. Several participants reported that the actions were unchallenging or that they found only one or two of the actions difficult. Other participants found the actions well-suited to their needs or appreciated the combination of easier and more difficult actions. Some participants noted that it was useful to practice everyday actions that would be commonly encountered. On the other hand, the disparity between practicing the actions at home and in real-life scenarios was discussed. |
| All participants felt that the intervention would benefit from a greater variety and choice of actions. It was suggested that individuals could be supported to select actions appropriate to them. Some participants would like the option to replace actions once a level of competence had been achieved or to be able to progress to more difficult actions. One participant felt that they would prefer to focus on one action at a time, according to their current needs. |
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| Theme 2: action observation and motor imagery |
| It was noted that watching the videos provided useful cues for improving performance, and one participant reported that this was particularly helpful for the more difficult actions. It was also suggested that watching the videos could increase awareness of variability in the observer’s own actions. However, one participant noted that they became distracted while watching the videos, so they may not have always fully attended to the presented action. |
| Participants generally reported a preference for viewing actions from the first-person perspective, which for some individuals could change over time. Comments indicated that the first-person video promoted motor imagery, although some participants appreciated seeing the third-person view first to obtain an overall understanding of the action. Some participants felt that it was helpful to see both perspectives, which might facilitate motor imagery and learning. |
| Individual differences in experiences of the motor imagery component of the training were highlighted. Some participants found it effortful to engage in motor imagery, which either improved over time or remained problematic, while other comments indicated that the importance of the imagery component might be unclear. Hearing the sounds associated with the actions was suggested to help in facilitating imagery. |
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| Theme 3: accommodating the training within everyday life with Parkinson’s |
| Participants generally found the training schedule manageable and were able to fit the session into their day, valuing the flexibility to work around other commitments and activities. However, one individual commented on the additional time needed to set up the objects in preparation for their session, which increased the daily time demands. Another person found that their sessions took quite some time to complete and that they had sacrificed other activities in order to fit in the training. The duration of the current intervention period was generally found to be acceptable and appropriate. |
| Some participants noticed that their ability to perform the actions was impacted by medication effects or fatigue, which could result in inconsistent performance at different times of the day. The variable nature of Parkinson’s, including fluctuation of symptoms and the way the condition could affect different actions, was also commented on by several participants. |
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| Theme 4: perceived effects including cognitive and psychological changes |
| Most participants noticed at least some degree of improvement in the actions trained within the intervention, although others did not perceive any change in their performance, which in some cases was suggested to relate to the suitability of the selected actions. The training had helped some participants in performing other everyday tasks. Comments suggested that this could relate to a change in attitude or mindset when approaching actions. |
| Some participants more explicitly referred to changes in awareness or use of action representation processes (observation and imagery) in everyday life, although some did not notice any such changes. Examples of applying imagery to specific tasks were provided, including tool use, dressing, getting out of bed, and moving through doorways. |
| Other changes such as increased confidence, sense of control, and self-efficacy were reported by some participants. |
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| Theme 5: the importance of motivation and feedback |
| Motivation was unanimously considered an important issue in home-based training, although individuals’ views on what would motivate them differed. |
| For some participants, the potential to improve movements through the training, or just the achievement associated with completing the daily sessions, was intrinsically motivating. Practicing more challenging actions, or a progression in the difficulty of actions, might also provide a source of motivation. |
| External sources of motivation were also highlighted. Some participants said that they would find performance-related feedback helpful. It was also suggested that more feedback and encouragement could be built into the app. |
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