Abstract: P803
Type: Poster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Background: Multimodal rehabilitation improves symptoms in persons with multiple sclerosis (PwMS), but these effects diminish with time, despite the well-known positive impact of exercise on fatigue and mobility.
Objective: We evaluated the efficacy of a 3-month, internet-based program (MS Intakt) on fatigue and mobility in PwMS after inpatient rehabilitation.
Methods: PwMS admitted to inpatient rehabilitation, age > 18 years, EDSS ≤ 6.0, fatigue (WEIMuS score ≥ 32) and willingness to participate were randomized into the intervention (IG) and control (CG) group. The IG underwent a 3-month home training program that was supervised via internet by sport therapists directly after rehabilitation, whereas the CG received usual care alone. The primary outcome was fatigue after 3 months (WEIMuS questionnaire). Secondary outcomes were quality of life (MSIS-29, EQ-5d), mobility (EDSS, 2min walking test, 10m walking test, Tinetti score), neuropsychological parameters (TAP alertness, TAP executive control) and questionnaires for physical activity. Measurements were done within the first week (T0) and at the end of rehabilitation (T1), at follow-up after 3 months (T2), and via mail after 6 months (T3). In addition, an economic evaluation was performed in both groups.
Results: 84 PwMS were included (41 IG, 43 CG), of whom 64 completed the study (33 IG, 64 % female, mean age 48.0 ± 6.5 yrs, disease duration 10.5 ± 4.7 yrs, median EDSS 4.5; 31 CG, 58 % female, age 45.8 ± 10.4 yrs, disease duration 9.1 ± 5.8 yrs, EDSS 4.0). At baseline, median WEIMuS scores were higher (indicating a higher degree of fatigue) in IG than in CG, but decreased similarly at T1 in both groups (IG: 45 vs. 31; CG: 39 vs. 26). However, WEIMuS scores increased in CG to 36 at T2 and remained there at T3, whereas in IG, fatigue further improved at 3 and 6 months (WEIMuS 29 and 27); the improvements at 3 months were significantly different between both groups (p< 0.0001). Similarly, MSIS-29 scores were better in both groups at T1, but remained stable at T2 only in IG.
The improvements in gait parameters were also more pronounced in IG.
Conclusion: The results of our study demonstrate that the effects of rehabilitation on fatigue, quality of life, and mobility can be maintained with an internet-based home training program for up to 3 - 6 months. Further studies are needed to investigate whether longer-lasting programs may have sustained effects on these disabling symptoms of PwMS.
Disclosure: No source of funding.
Anna-Karolina Bures: nothing to disclose
Sarah Kuld: nothing to disclose
Ann-Christin Weiland: nothing to disclose
Klaus Gusowski: nothing to disclose
Klaus Pfeifer has received research grants from Biogen and Novartis. None resulted in a conflict of interest.
Peter Flachenecker has received speaker´s fees and honoraria for advisory boards from Bayer, Biogen, Genzyme, Merck-Serono, Novartis, Roche and Teva. None resulted in a conflict of interest.
Abstract: P803
Type: Poster
Abstract Category: Therapy - symptomatic - 33 Treatment of specific symptoms
Background: Multimodal rehabilitation improves symptoms in persons with multiple sclerosis (PwMS), but these effects diminish with time, despite the well-known positive impact of exercise on fatigue and mobility.
Objective: We evaluated the efficacy of a 3-month, internet-based program (MS Intakt) on fatigue and mobility in PwMS after inpatient rehabilitation.
Methods: PwMS admitted to inpatient rehabilitation, age > 18 years, EDSS ≤ 6.0, fatigue (WEIMuS score ≥ 32) and willingness to participate were randomized into the intervention (IG) and control (CG) group. The IG underwent a 3-month home training program that was supervised via internet by sport therapists directly after rehabilitation, whereas the CG received usual care alone. The primary outcome was fatigue after 3 months (WEIMuS questionnaire). Secondary outcomes were quality of life (MSIS-29, EQ-5d), mobility (EDSS, 2min walking test, 10m walking test, Tinetti score), neuropsychological parameters (TAP alertness, TAP executive control) and questionnaires for physical activity. Measurements were done within the first week (T0) and at the end of rehabilitation (T1), at follow-up after 3 months (T2), and via mail after 6 months (T3). In addition, an economic evaluation was performed in both groups.
Results: 84 PwMS were included (41 IG, 43 CG), of whom 64 completed the study (33 IG, 64 % female, mean age 48.0 ± 6.5 yrs, disease duration 10.5 ± 4.7 yrs, median EDSS 4.5; 31 CG, 58 % female, age 45.8 ± 10.4 yrs, disease duration 9.1 ± 5.8 yrs, EDSS 4.0). At baseline, median WEIMuS scores were higher (indicating a higher degree of fatigue) in IG than in CG, but decreased similarly at T1 in both groups (IG: 45 vs. 31; CG: 39 vs. 26). However, WEIMuS scores increased in CG to 36 at T2 and remained there at T3, whereas in IG, fatigue further improved at 3 and 6 months (WEIMuS 29 and 27); the improvements at 3 months were significantly different between both groups (p< 0.0001). Similarly, MSIS-29 scores were better in both groups at T1, but remained stable at T2 only in IG.
The improvements in gait parameters were also more pronounced in IG.
Conclusion: The results of our study demonstrate that the effects of rehabilitation on fatigue, quality of life, and mobility can be maintained with an internet-based home training program for up to 3 - 6 months. Further studies are needed to investigate whether longer-lasting programs may have sustained effects on these disabling symptoms of PwMS.
Disclosure: No source of funding.
Anna-Karolina Bures: nothing to disclose
Sarah Kuld: nothing to disclose
Ann-Christin Weiland: nothing to disclose
Klaus Gusowski: nothing to disclose
Klaus Pfeifer has received research grants from Biogen and Novartis. None resulted in a conflict of interest.
Peter Flachenecker has received speaker´s fees and honoraria for advisory boards from Bayer, Biogen, Genzyme, Merck-Serono, Novartis, Roche and Teva. None resulted in a conflict of interest.