Individual telerehabilitation program for improving balance in people with MS

ABSTRACT

Introduction: During the Covid-19 pandemic, the provision of rehabilitation care to people with MS was significantly reduced (in addition, many patients were afraid to visit medical and sports facilities). An alternative (in these cases) could be telerehabilitation (ie the provision of rehabilitation services at a distance). The aim of our pilot study was to evaluate the feasibility of this form of rehabilitation in people with MS with balance disorders. Method(s) Our pilot study included 20 patients with MS with balance disorders. The intervention lasted 12 weeks. The experimental group underwent individual telerehabilitation (twice a week, 45 individual telerehabilitation), which consisted of balance and strength exercises with a physiotherapist, using the Homebalance system and other simple tools). The control group received regular rehabilitation care (outpatient individual physiotherapy). Functional tests were selected to assess the gait and balance disorders Timed Up and Go (TUG), TUG with dual cognitive task and Berg Balance Scale (BBS). Subjective perceptions of gait, balance and fatigue disorders were evaluated with standardized questionnaires Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), Falls Efficacy Scale International (FES-I), Activity Balance Confidence Scale (ABC Scale ). Result(s) The mean age of participants was 51 years (34-65 years), with the mean disease duration was 17 years (4-29 years) with a median neurological disability EDSS 5 (3-6.5). There was a significant improvement in the experimental group in the functional mobility test-TUG (p=0.048), balance-BBS (p=0.002) and in the standardized ABC Scale questionnaire (p=0.041). Conclusion(s) The results of the pilot study suggest that individual telerehabilitation could be an alternative to routine rehabilitation care for the treatment of balance and mobility disorders in patients with MS (suitable, for example, for people with a more distant place of residence or in case of new pandemic restrictions).