Supervised exercises versus telerehabilitation. Benefits for persons with multiple sclerosis

Tarakçı, Ela; Tarakçı, Devrim; Hajebrahimi, Farzin; Budak, Miray

doi:10.1111/ane.13448

Cited by 20 publications

(43 citation statements)

References 40 publications

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“…Twelve studies were comparator trials, and 20 were single-arm trials. Three single-arm trials were excluded due to the required information not being received via author contact 24–26…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing

et al. 2022

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ObjectiveTo investigate the effectiveness of videoconferencing exercise interventions for people with chronic diseases.DesignSystematic review incorporating meta-analysis.Data sourcesPubMed, Cinahl, MEDLINE, Web of Science, Embase and Scopus.Eligibility criteriaThe current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Trials analysing participants with chronic disease undergoing aerobic and/or resistance exercise training over videoconferencing, with exercise capacity and/or quality of life outcomes were included. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life. Risk of bias was analysed using the Downs and Black quality checklist and the certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation (GRADE).ResultsThirty-two trials were included in this review, of which 12 were comparator trials. Small–moderate between-group (videoconferencing vs comparator) effects favouring videoconferencing were seen for studies using a non-exercising comparator for exercise capacity (standardised mean difference (SMD)=0.616, 95% CI 0.278 to 0.954; p=<0.001) and quality of life (SMD=0.400, 95% CI 0.099 to 0.701; p=0.009). Small effects favouring videoconferencing were observed for studies using an exercising comparator for quality of life (SMD=0.271, 95% CI 0.028 to 0.515; p=0.029) and exercise capacity (SMD=0.242, 95% CI 0.059 to 0.426; p=0.009). Moderate risk of bias was identified for included studies (16.3±3.6/28), with GRADE certainty ratings of ‘low’ (quality of life) and ‘moderate’ (exercise capacity). Session attendance was 70% and was reported in 23 trials. No serious adverse events relating to videoconferencing were found. Nine trials documented the total number of technical issues that occurred in 17% of the sessions. Positive satisfaction outcomes were associated with ease of access and usefulness of technology.ConclusionIn patients with chronic disease, videoconferencing exercise interventions appear to be feasible and effective for improving exercise capacity and quality of life. More robust methodology is needed in future studies to improve the certainty of the evidence.PROSPERO registration numberCRD42020191243.

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“…Twelve studies were comparator trials, and 20 were single-arm trials. Three single-arm trials were excluded due to the required information not being received via author contact 24–26…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing

et al. 2022

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“…Despite the lack of a control group for comparison, these findings are consistent with previous studies that have demonstrated improvements in walking ability and balance with 12 weeks of homebased and online exercise training in individuals with MS. 29 A systematic review by Perrochon et al 26 found exercise-based gaming interventions at home to be equally effective to conventional therapy. Similarly, Tarakci et al 30 found in-person and telerehabilitation to be equally effective in MS. A study by Jeong et al 31 found that MS-specific physical telerehabilitation produces superior improvements in quality of life as compared with newsletters only. Although prior evidence supports the effectiveness of home-based, 26,32 telehealth, 27,33 or in-person group exercise programs 20 on physical, mental, and social aspects of MS, a combined virtual and group exercise model has not been previously studied.…”

Section: Functional Status Changesmentioning

confidence: 88%

Feasibility, Outcomes, and Perceptions of a Virtual Group Exercise Program in Multiple Sclerosis

Garg,

Rutherfurd,

Labrum

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: Individuals with multiple sclerosis (MS) frequently report low physical activity and psychosocial support due to concerns with transportation, time, finances, access to services, and lack of caregiver support. These barriers can be addressed by online group interventions; however, utility of such programs in individuals with MS has not been examined yet. The purpose of this retrospective study was, therefore, to (a) investigate the feasibility, safety, and outcomes of a virtual group exercise program in individuals with MS, and (b) explore the participant perceptions after the program. Methods: Retrospective data from the medical records of 17 individuals with MS (mean [SD] age = 53.5 [12.3] years, body mass index = 28.2 [7.2]) who completed the virtual 13-week group exercise program, pre- and posttraining functional status questionnaires, and the end-of-program feedback were extracted. The exercise program included aerobic, resistance, balance, and flexibility training components recommended for people with MS. Feasibility, safety, outcomes, and participant perceptions were determined by adherence to the prescribed daily exercise dosage, number of adverse events, within-group differences in self-reported functional status, and thematic analysis of the participant feedback, respectively. Results: Participants were adherent (79%), reported minimal adverse effects, and demonstrated significant changes (P < 0.05) in functional status posttraining. Several themes on the perceived barriers, facilitators, and suggestions for improvement were identified. Discussion and Conclusions: A virtual 13-week group exercise program can be feasible, safe, effective, and well received by individuals with MS. Future research should investigate the dose-response effectiveness of telehealth and compare various telehealth models of exercise training using large randomized controlled trials. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A434, which demonstrates an overview of the study).

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“…Tarakci et al, 2021 compared an in-person rehabilitation program with a telerehabilitation program. After 12 weeks of training, the results were similar in the two groups for fatigue and activity level [52]. Manns et al, 2020 demonstrated a reduction of fatigue after a combined intervention (SitLess and MoveMore) but the difference was not significant compared to usual care [46].…”

Section: Rehabilitationmentioning

confidence: 91%

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

et al. 2021

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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.

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Supervised exercises versus telerehabilitation. Benefits for persons with multiple sclerosis

Cited by 20 publications

References 40 publications

Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing

Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing

Feasibility, Outcomes, and Perceptions of a Virtual Group Exercise Program in Multiple Sclerosis

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

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