Is mHealth a Useful Tool for Self-Assessment and Rehabilitation of People with Multiple Sclerosis? A Systematic Review

Abstract

The development of mobile technology and mobile Internet offers new possibilities in rehabilitation and clinical assessment in a longitudinal perspective for multiple sclerosis management. However, because the mobile health applications (mHealth) have only been developed recently, the level of evidence supporting the use of mHealth in people with multiple sclerosis (pwMS) is currently unclear. Therefore, this review aims to list and describe the different mHealth available for rehabilitation and self-assessment of pwMS and to define the level of evidence supporting these interventions for functioning problems categorized within the International Classification of Functioning, Disability and Health (ICF). In total, 36 studies, performed with 22 different mHealth, were included in this review, 30 about rehabilitation and six for self-assessment, representing 3091 patients. For rehabilitation, most of the studies were focusing on cognitive function and fatigue. Concerning the efficacy, we found a small but significant effect of the use of mHealth for cognitive training (Standardized Mean Difference (SMD) = 0.28 [0.12; 0.45]) and moderate effect for fatigue (SMD = 0.61 [0.47; 0.76]). mHealth is a promising tool in pwMS but more studies are needed to validate these solutions in the other ICF categories. More replications studies are also needed as most of the mHealth have only been assessed in one single study.

Mobile health solutions: An opportunity for rehabilitation in low- and middle income countries?

“…To evaluate the current use of mHealth solutions across the world, we performed a second analysis of the latest reviews summarizing the efficacy of mHealth applications for stroke ( 16 ), healthy aging ( 17 ), Parkinson's disease ( 18 ), and multiple sclerosis ( 19 ). A total of 132 studies were included in this analysis.…”

“…Concerning the efficacy, a small but significant effect was found for the use of mHealth for cognitive training [Standardized Mean Difference (SMD) = 0.28 (0.12; 0.45)] and a moderate effect for fatigue [SMD = 0.61 (0.47; 0.76)]. However, more replication studies are also needed as most of the mHealth have only been assessed in one single study ( 19 ).…”

“…The use of mobile technology and eHealth may provide an alternative to the aforementioned limitations of care or serve as a complement to existing rehabilitation programs. At least in high-income countries, the development and implementation of mHealth enhance the scope and potential of the healthcare sector ( 16 – 19 ). Mobile technology and eHealth have been of great importance in the context of the COVID-19 pandemic during the different lockdowns and when physical restrictions were imposed and access to rehabilitation services and care was limited ( 20 ).…”

Effect of Electronic Medical Record Management Systems on the Disease Activity and Frequency of Outpatient Visits of Patients with Ankylosing Spondylitis: A cross-sectional

“…With advances in mobile technologies, electric health (eHealth) and smartphone applications (known as apps) have been developed to facilitate the transmission of information related to infectious diseases in numerous low-income countries, such as some nations in Africa [5]. Furthermore, smart apps have been extensively used for standard clinical evaluations and monitoring diseases and changes in the health status of patients with chronic health conditions [6], including asthma [7], obesity, diabetes [8], hypertension, cardiovascular disease [9], and multiple sclerosis [10]. Such app-based data systems ensure complete and timely data collection [11].…”

Digital Innovation in Multiple Sclerosis Management

“…They laid out several MS-specific use cases, such as single-use, social, integrated, and complex eHealth solutions, and collected factors of success for eHealth interventions in MS. In a second review, Bonnechère et al focused on the existing clinical evidence of mobile health (mHealth) technologies in the rehabilitation and self-assessment of pwMS [ 11 ]. They reported small benefits of mHealth for cognitive functioning and moderate benefits for fatigue.…”