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Feasibility of Telerehabilitation in Patients with Significant Mobility Disability due to Multiple Sclerosis
Joseph Finkelstein, McKenzie Bedra, Susan S. Conroy, Christopher Bever
Baltimore, MD, USA.
OBJECTIVE: We developed a telerehabilitation system to support home-based exercise in patients with multiple sclerosis (PwMS) with significant mobility disability. The system guides patients in performing seated individualized flexibility and resistance exercises. Aerobic exercise is performed using a remotely controlled arm/leg mini-bike in active and passive modes. The goal of this study was to assess feasibility and acceptance of this approach.
BACKGROUND: Recent studies demonstrated that exercise interventions in significantly disabled PwMS resulted in endurance and strength improvement and reduction of fatigue and spasticity. However engagement in long-term exercise training is limited in these patients due to multiple barriers including mobility, access to an exercise facility, and cost.
DESIGN/METHODS: Ten PwMS with significant mobility disability were instructed how to use the telerehabilitation system and were then asked to use it independently according to predefined set of tasks. Feasibility was assessed by ability of study participants to successfully follow exercise tasks provided by a touch screen tablet. Telerehabilitation acceptance was measured by an attitudinal survey.
RESULTS: Participant characteristics were: age=53±11, PDDS=5.3±2.4, years with MS=16±9. Average time required to train the patients to use the telerehabilitation system at home for flexibility and resistance exercises was 11±3 minutes, for active arm/leg biking - 3±1 minutes, and for passive biking - 3±2 minutes. All patients were able to successfully complete flexibility and resistance exercises and navigate the interface for arm biking exercise. Heart rate readings were affected by noise in some subjects. Active leg cycling was completed by 50% of patients; another half was unable to use it due to severe mobility impairment. Passive leg cycling supported by a splinting device was successfully operated by 100%.
CONCLUSION: Attitudinal survey demonstrated high support for the system. Majority of the patients expressed interest in using the system in the future.
Joseph Finkelstein, McKenzie Bedra, Susan S. Conroy, Christopher Bever
Baltimore, MD, USA.
OBJECTIVE: We developed a telerehabilitation system to support home-based exercise in patients with multiple sclerosis (PwMS) with significant mobility disability. The system guides patients in performing seated individualized flexibility and resistance exercises. Aerobic exercise is performed using a remotely controlled arm/leg mini-bike in active and passive modes. The goal of this study was to assess feasibility and acceptance of this approach.
BACKGROUND: Recent studies demonstrated that exercise interventions in significantly disabled PwMS resulted in endurance and strength improvement and reduction of fatigue and spasticity. However engagement in long-term exercise training is limited in these patients due to multiple barriers including mobility, access to an exercise facility, and cost.
DESIGN/METHODS: Ten PwMS with significant mobility disability were instructed how to use the telerehabilitation system and were then asked to use it independently according to predefined set of tasks. Feasibility was assessed by ability of study participants to successfully follow exercise tasks provided by a touch screen tablet. Telerehabilitation acceptance was measured by an attitudinal survey.
RESULTS: Participant characteristics were: age=53±11, PDDS=5.3±2.4, years with MS=16±9. Average time required to train the patients to use the telerehabilitation system at home for flexibility and resistance exercises was 11±3 minutes, for active arm/leg biking - 3±1 minutes, and for passive biking - 3±2 minutes. All patients were able to successfully complete flexibility and resistance exercises and navigate the interface for arm biking exercise. Heart rate readings were affected by noise in some subjects. Active leg cycling was completed by 50% of patients; another half was unable to use it due to severe mobility impairment. Passive leg cycling supported by a splinting device was successfully operated by 100%.
CONCLUSION: Attitudinal survey demonstrated high support for the system. Majority of the patients expressed interest in using the system in the future.