The Effect of Individual Telerehabilitation on Postural Stability in People With Multiple Sclerosis, A Pilot Study
Vol.18,No.2(2024)
Background: The aim of our pilot study was to assess the feasibility and effectiveness of individual balance telerehabilitation for people with multiple sclerosis (MS).
Methods: In this pilot study 20 individuals with MS with balance impairment were included (10 in experimental, 10 in control group). The experimental group underwent 12 weeks of individual telerehabilitation (with direct synchronous contact between the physiotherapist and the patient). The control group received conventional outpatient physiotherapy. The standardized tests of balance and functional mobility were assessed at baseline and after intervention.
Results: Comparing the two groups, the experimental group achieved statistically significant improvement in balance: the BBS test (p=0.002), TUG (p=0.048), functional test standing on one limb (p=0.01), and subjectively perceived balance with the ABC Scale questionnaire (p=0.041). The substantive significance (Cohen's d) when comparing the two groups reached a large effect size in the BBS (d=0.83) and standing on one limb (d=1.06) and in the MSWS-12 (d=0.78) and ABC Scale questionnaire (d=0.78).
Conclusion: Telerehabilitation interventions represent an increasing trend and our data suggest that individually delivered online telerehabilitation can be effective in the treatment of balance and functional mobility disorders in MS.
multiple sclerosis; balance; postural stability; rehabilitation; telerehabilitation
Amorim, P., Brito, D., Castelo-Branco, M., Fàbrega, C., Gomes da Costa, F., Martins, H., Gonçalves, L., Gonçalves, L. M., Martin, V., Milner, J., Nêveda, R., Ferreira, A. N., Pardo, R., Peralta-Santos, A., Pessoa, T., Silva, J., Salvador Vergès, À. (2020). Telehealth Opportunities in the COVID-19 Pandemic Early Days: What Happened, Did Not Happen, Should Have Happened, and Must Happen in the Near Future? Telemed J E Health, 27(10):1194-1199.
Agostini, M., Moja, L., Banzi, R., Pistotti, V., Tonin, P., Venneri, A., & Turolla, A. (2015). Telerehabilitation and recovery of motor function: a systematic review and meta-analysis. J Telemed Telecare, 21(4):202-213.
Duruturk N. (2020). Telerehabilitation intervention for type 2 diabetes. World J Diabetes, 11(6):218-226.
Cavalheiro AH, Silva Cardoso J, Rocha A, Moreira E, Azevedo LF. (2021). Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. Health Serv Insights, 14: 11786329211021668.
Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. (2020). Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer? Phys Ther, 100(8):1260-1264.
Gandolfi, M., Geroin, C., Dimitrova, E., Boldrini, P., Waldner, A., Bonadiman, S., Picelli, A., Regazzo, S., Stirbu, E., Primon, D., Bosello, C., Gravina, A. R., Peron, L., Trevisan, M., Garcia, A. C., Menel, A., Bloccari, L., Valè, N., Saltuari, L., Tinazzi, M., Smania, N. (2017). Virtual Reality Telerehabilitation for Postural Instability in Parkinson’s Disease: A Multicenter, Single-Blind, Randomized, Controlled Trial. Biomed Res Int, 2017: 7962826.
Laver, K. E., Adey-Wakeling, Z., Crotty, M., Lannin, N. A., George, S., Sherrington, C. (2020). Telerehabilitation services for stroke. Cochrane Database Syst Rev, 1(1): CD010255.
Sarfo FS, Ulasavets U, Opare-Sem OK, Ovbiagele B. (2018). Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature. J Stroke Cerebrovasc Dis, 27(9):2306-2318.
Di Tella S, Pagliari C, Blasi V, Mendozzi L, Rovaris M, Baglio F. (2020) Integrated telerehabilitation approach in multiple sclerosis: A systematic review and meta-analysis. J Telemed Telecare, 26(7-8):385-399.
Tallner A, Streber R, Hentschke C, Morgott M, Geidl W, Mäurer M, Pfeifer K. (2016). Internet-Supported Physical Exercise Training for Persons with Multiple Sclerosis—A Randomised, Controlled Study. Int J Mol Sci, 17(10): 1667.
Yeroushalmi S, Maloni H, Costello K, Wallin MT. (2020). Telemedicine and multiple sclerosis: A comprehensive literature review. J Telemed Telecare, 26(7-8):400-413.
Cameron MH, Nilsagard Y. (2018). Balance, gait, and falls in multiple sclerosis. Handb Clin Neurol, 159:237-250.
Prosperini L, Castelli L. (2018). Spotlight on postural control in patients with multiple sclerosis. Degener Neurol Neuromuscul Dis, 8:25-34.
van Asch P. (2011). Impact of Mobility Impairment in Multiple Sclerosis 2 - Patients’ Perspectives. European Neurological Review, 6(2):115-120.
Fjeldstad-Pardo C, Thiessen A, Pardo G. (2018). Telerehabilitation in Multiple Sclerosis: Results of a Randomized Feasibility and Efficacy Pilot Study. Int J Telerehabil, 10(2):55-64.
Moumdjian, L., Smedal, T., Arntzen, E. C., van der Linden, M. L., Learmonth, Y., Pedullà, L., Tacchino, A., Novotna, K., Kalron, A., Yazgan, Y. Z., Nedeljkovic, U., Kos, D., Jonsdottir, J., Santoyo-Medina, C., & Coote, S. (2022). Impact of the COVID-19 Pandemic on Physical Activity and Associated Technology Use in Persons With Multiple Sclerosis: An International RIMS-SIG Mobility Survey Study. Arch Phys Med Rehabil, 103(10):2009-2015.
Janatová M, Tichá M, Melecký R, Hána K, Švestková O, Jeřábek J. (2016). Pilotní studie využití tenzometrické plošiny v domácí terapii poruch rovnováhy. Cesk Slov Neurol N, 79/112(5):591-594.
Janatová M, Šollová M, Švestková O. (2018). Telerehabilitace u pacienta s poruchou rovnováhy po cévní mozkové příhodě. Rehabilitace a Fyzikalni Lekarstvi, 25(1):28-33.
Brichetto G, Spallarossa P, de Carvalho ML, Battaglia MA. (2013). The effect of Nintendo® Wii® on balance in people with multiple sclerosis: a pilot randomized control study. Mult Scler, 19(9):1219-1221.
Gopal A, Bonanno V, Block VJ, Bove RM. (2022). Accessibility to Telerehabilitation Services for People With Multiple Sclerosis: Analysis of Barriers and Limitations. Int J MS Care, 24(4):1-25.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright © 2024 Barbora Grosserova, Markéta Janatová, Dana Horáková, Klára Novotná