Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

Lorna Paul, Linda Renfrew, Jennifer Freeman, Heather Murray, Belinda Weller, Paul Mattison, Alex McConnachie, Robert Heggie, Olivia Wu, Elaine H. Coulter*

*Corresponding author for this work

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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.
Original languageEnglish
Pages (from-to)473-484
Number of pages12
JournalClinical Rehabilitation
Volume33
Issue number3
Early online date4 Dec 2018
DOIs
Publication statusPublished - 1 Mar 2019

Keywords

  • physiotherapy
  • exercise
  • multiple sclerosis
  • internet

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