Abstract
Methods: Inclusion criteria were diagnosis of MS, internet access, residing within 300km of Saskatoon, and exercising less than twice weekly. Participants were randomized (2:1) to a physiotherapist-guided web-based home exercise program or physiotherapist-prescribed written home exercise program. The primary outcome was adherence (number of exercise sessions over 26 weeks). Secondary outcomes were described in terms of means and effect sizes.
Results: There were 48 participants: mean age 54.3y (SD 11.9), disease duration 19.5y (SD 11.0) and mean Patient-Determined Disease Steps 4.4 (SD 1.6). There was no significant difference in adherence between groups: web group (mean 38.9, SD 28.1); comparator group (mean 34.6, SD 40.8; U=198.5, p=.208, Hedges’ g 0.13). Nearly 50% of participants (23/48) exercised ≥ twice per week for at least 13 of the 26 weeks. Adherence was highest in the web-based subgroup of wheelchair users. Medium effect sizes were found for HADS - anxiety subscale and in ambulatory participants for TUG. There were no adverse events.
Conclusions: There was no difference in exercise adherence between the web-based and active comparator groups. There was no worsening on secondary outcomes or adverse events, supporting the safety of web-based physiotherapy. More research is needed to determine if wheelchair users might be most likely to benefit from web-based physiotherapy.
| Original language | English |
|---|---|
| Journal | International Journal of MS Care |
| Early online date | Jan 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - Jan 2020 |
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Keywords
- multiple sclerosis
- exercise
- adherence
- physiotherapy
- telerehabilitation
Cite this
}
Adherence to physiotherapy-guided web-based exercise for persons living with moderate-to-severe multiple sclerosis: a randomized-controlled pilot study. / Donkers, Sarah; Nickel, Darren; Paul, Lorna; Wiegers, Shane R.; Knox, Katherine B.
In: International Journal of MS Care, 01.2020.Research output: Contribution to journal › Article
TY - JOUR
T1 - Adherence to physiotherapy-guided web-based exercise for persons living with moderate-to-severe multiple sclerosis: a randomized-controlled pilot study
AU - Donkers, Sarah
AU - Nickel, Darren
AU - Paul, Lorna
AU - Wiegers, Shane R.
AU - Knox, Katherine B.
N1 - Acceptance in SAN AAM: made open, with rights statement in line with previous acceptances to jnl. 6/12/19 DC - ET/DC to update rights statement upon publication Only year available for earliest pub date - added current month as available in January. 12/01/2020 TM
PY - 2020/1
Y1 - 2020/1
N2 - Background: Options to support adherence with physical activity in moderate-to-severe MS are needed. The primary aim was to evaluate adherence to a web-based, individualized exercise program in moderate-to-severe MS. Secondary aims were to explore changes in MSIS-29, HADS, grip strength, T25FWT, and TUG.Methods: Inclusion criteria were diagnosis of MS, internet access, residing within 300km of Saskatoon, and exercising less than twice weekly. Participants were randomized (2:1) to a physiotherapist-guided web-based home exercise program or physiotherapist-prescribed written home exercise program. The primary outcome was adherence (number of exercise sessions over 26 weeks). Secondary outcomes were described in terms of means and effect sizes. Results: There were 48 participants: mean age 54.3y (SD 11.9), disease duration 19.5y (SD 11.0) and mean Patient-Determined Disease Steps 4.4 (SD 1.6). There was no significant difference in adherence between groups: web group (mean 38.9, SD 28.1); comparator group (mean 34.6, SD 40.8; U=198.5, p=.208, Hedges’ g 0.13). Nearly 50% of participants (23/48) exercised ≥ twice per week for at least 13 of the 26 weeks. Adherence was highest in the web-based subgroup of wheelchair users. Medium effect sizes were found for HADS - anxiety subscale and in ambulatory participants for TUG. There were no adverse events.Conclusions: There was no difference in exercise adherence between the web-based and active comparator groups. There was no worsening on secondary outcomes or adverse events, supporting the safety of web-based physiotherapy. More research is needed to determine if wheelchair users might be most likely to benefit from web-based physiotherapy.
AB - Background: Options to support adherence with physical activity in moderate-to-severe MS are needed. The primary aim was to evaluate adherence to a web-based, individualized exercise program in moderate-to-severe MS. Secondary aims were to explore changes in MSIS-29, HADS, grip strength, T25FWT, and TUG.Methods: Inclusion criteria were diagnosis of MS, internet access, residing within 300km of Saskatoon, and exercising less than twice weekly. Participants were randomized (2:1) to a physiotherapist-guided web-based home exercise program or physiotherapist-prescribed written home exercise program. The primary outcome was adherence (number of exercise sessions over 26 weeks). Secondary outcomes were described in terms of means and effect sizes. Results: There were 48 participants: mean age 54.3y (SD 11.9), disease duration 19.5y (SD 11.0) and mean Patient-Determined Disease Steps 4.4 (SD 1.6). There was no significant difference in adherence between groups: web group (mean 38.9, SD 28.1); comparator group (mean 34.6, SD 40.8; U=198.5, p=.208, Hedges’ g 0.13). Nearly 50% of participants (23/48) exercised ≥ twice per week for at least 13 of the 26 weeks. Adherence was highest in the web-based subgroup of wheelchair users. Medium effect sizes were found for HADS - anxiety subscale and in ambulatory participants for TUG. There were no adverse events.Conclusions: There was no difference in exercise adherence between the web-based and active comparator groups. There was no worsening on secondary outcomes or adverse events, supporting the safety of web-based physiotherapy. More research is needed to determine if wheelchair users might be most likely to benefit from web-based physiotherapy.
KW - multiple sclerosis
KW - exercise
KW - adherence
KW - physiotherapy
KW - telerehabilitation
U2 - 10.7224/1537-2073.2019-048
DO - 10.7224/1537-2073.2019-048
M3 - Article
ER -