Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study. (March 2019)

• Record Type: Journal Article
• Authors: Paul, Lorna; Renfrew, Linda; Freeman, Jennifer; Murray, Heather; Weller, Belinda; Mattison, Paul; McConnachie, Alex; Heggie, Robert; Wu, Olivia; Coulter, Elaine H
• Is Part Of: Clinical rehabilitation. Volume 33:Number 3(2019)
• Page Start: 473
• Page End: 484
• Publication Date: 2019-03
• Subjects: Physiotherapy -- exercise -- multiple sclerosis -- Internet; Medical rehabilitation -- Periodicals; 617.03
• DOI: 10.1177/0269215518817080
• Languages: English
• ISSNs: 0269-2155

Abstract

Objective: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis. Design: Multi-centre, randomized controlled, feasibility study. Setting: Three multiple sclerosis out-patient centres. Participants: A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4–6.5). Interventions: Participants were randomized to a six-month individualized, home exercise programme delivered via web-based physiotherapy ( n = 45; intervention) or a sheet of exercises ( n = 45; active comparator). Outcome measures: Outcome measures (0, three, six and nine months) included adherence, two-minute walk test, 25 foot walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists. Results: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40%–63% and 53%–71% in the intervention and comparator groups. There was no difference in the two-minute walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at six-month Intervention-81.6(32.75)m, Comparator-74.8(36.16)m. There were no significant changes over time in other outcome measures except the EuroQol-5 Dimension at six months which decreased in the active comparator group. For a difference of 8(17.4)m in two-minute walk test between groups, 76 participants/group would be required (80% power, P > 0.05) for a future randomized controlled trial. Conclusion: No changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.