Contributions
Abstract: P780
Type: Poster
Abstract Category: RIMS - Multi-disciplinary rehabilitation
Background: MS commonly results in physical and cognitive disability. Functional improvement of established physical deficits can be achieved through rehabilitation methods to include physical therapy (PT). Access to specialized rehabilitation services is limited due to a variety of factors including availability, geographical distance, mobility limitations, transportation difficulties, and financial constraints. Telecommunication technology offers the capacity to supervise and direct a PT program remotely through audio and visual real-time communication.
Objectives: Demonstrate the feasibility of a tele-health rehabilitation program in individuals with ambulatory deficits secondary to MS and to evaluate its efficacy when compared to conventional physical therapy.
Methods: This was a single-center, prospective, randomized, three-arm, evaluator blinded, 8-week study. Thirty individuals were included (female 69%, mean age 54.7 years, RMS 60%. SPMS 23%, PPMS 17%, mean EDSS 4.3). A home-based exercise program (HEP) was performed unsupervised 5 days a week for 8 weeks. Interventions were as follows: Group 1- HEP alone; Group 2- HEP plus remote PT supervised via audio and visual real-time telecommunication 2-3 times per week; Group 3- HEP plus in-person PT at the medical facility 2-3 times per week. Patient-reported outcomes and gait and balance assessments (reported separately) were performed.
Results: Patient-reported outcomes showed improvement from baseline in the Modified fatigue impact scale (MFIS) for groups 2 (p=0.05) and 3 (p=0.01) and SF36-mental (SF36m) for groups 2 (p=0.04) and 3 (p=0.01). Groups 2 and 3 were comparatively equivalent in SF36m p=0.06, balance confidence p=0.47, MFIS p=0.37, and self-efficacy p=0.79. Group 3 was better than groups 1 and 2 only in the SF36-physical. One participant dropped out due to an MS relapse.
Conclusions: Telerehabilitation is a convenient and practical method to perform PT in MS individuals and is overall equivalent to conventional in-person PT as measured by patient reported outcomes of fatigue, confidence and self-efficacy. Gait and balance outcomes were also favorable and are presented separately. Telerehabilitation should be researched further and used more extensively as a mean to improve function and quality of life in MS.
Disclosure:
Cecilie Fjeldstad, PhD: nothing to disclose
Amy Thiessen, PT: nothing to disclose
Gabriel Pardo, MD: nothing to disclose
This project was funded in part by the National Multiple Sclerosis Society
Abstract: P780
Type: Poster
Abstract Category: RIMS - Multi-disciplinary rehabilitation
Background: MS commonly results in physical and cognitive disability. Functional improvement of established physical deficits can be achieved through rehabilitation methods to include physical therapy (PT). Access to specialized rehabilitation services is limited due to a variety of factors including availability, geographical distance, mobility limitations, transportation difficulties, and financial constraints. Telecommunication technology offers the capacity to supervise and direct a PT program remotely through audio and visual real-time communication.
Objectives: Demonstrate the feasibility of a tele-health rehabilitation program in individuals with ambulatory deficits secondary to MS and to evaluate its efficacy when compared to conventional physical therapy.
Methods: This was a single-center, prospective, randomized, three-arm, evaluator blinded, 8-week study. Thirty individuals were included (female 69%, mean age 54.7 years, RMS 60%. SPMS 23%, PPMS 17%, mean EDSS 4.3). A home-based exercise program (HEP) was performed unsupervised 5 days a week for 8 weeks. Interventions were as follows: Group 1- HEP alone; Group 2- HEP plus remote PT supervised via audio and visual real-time telecommunication 2-3 times per week; Group 3- HEP plus in-person PT at the medical facility 2-3 times per week. Patient-reported outcomes and gait and balance assessments (reported separately) were performed.
Results: Patient-reported outcomes showed improvement from baseline in the Modified fatigue impact scale (MFIS) for groups 2 (p=0.05) and 3 (p=0.01) and SF36-mental (SF36m) for groups 2 (p=0.04) and 3 (p=0.01). Groups 2 and 3 were comparatively equivalent in SF36m p=0.06, balance confidence p=0.47, MFIS p=0.37, and self-efficacy p=0.79. Group 3 was better than groups 1 and 2 only in the SF36-physical. One participant dropped out due to an MS relapse.
Conclusions: Telerehabilitation is a convenient and practical method to perform PT in MS individuals and is overall equivalent to conventional in-person PT as measured by patient reported outcomes of fatigue, confidence and self-efficacy. Gait and balance outcomes were also favorable and are presented separately. Telerehabilitation should be researched further and used more extensively as a mean to improve function and quality of life in MS.
Disclosure:
Cecilie Fjeldstad, PhD: nothing to disclose
Amy Thiessen, PT: nothing to disclose
Gabriel Pardo, MD: nothing to disclose
This project was funded in part by the National Multiple Sclerosis Society