Chanpimol Shane, Benson Kimberly, Maloni Heidi, Conroy Susan, Wallin Mitchell
Neurology Service, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC 20422 USA.
MS Center of Excellence, Veterans Affairs Medical Center, Washington, DC USA.
Arch Physiother. 2020 Oct 1;10:18. doi: 10.1186/s40945-020-00089-5. eCollection 2020.
Physical rehabilitation services are an important component of treatment for persons with multiple sclerosis (PwMS) to improve and maintain physical mobility. However, PwMS often have significant barriers to outpatient physical therapy (PT) services including mobility deficits and lack of transportation. The integration of exercise gaming (exergaming) and telehealth into clinical PT practices may overcome these barriers. The overarching purpose of this pilot study was to evaluate the acceptability and effects of an individualized telePT intervention using exergaming.
Ten individuals with multiple sclerosis (MS) completed a 12-week exergaming (Jintronix®) telerehabilitation intervention. In order to measure the acceptability of the telerehabilitation intervention, adherence was measured through the tablet-based rehabilitation software and each participant completed a satisfaction questionnaire. Clinical outcome measures were assessed at baseline and post-intervention. To evaluate the efficacy of this intervention, the following measures of physical function and fatigue were included; the Short Physical Performance Battery (SPPB), 25-Foot Walk (25FW), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS), and the 2-Minute Walk Test (2MWT). Clinical outcomes were analyzed using the Sign test and Wilcoxon signed rank test. All other data were evaluated using descriptive statistics.
After the intervention, participants demonstrated significant improvements in ambulation speed during the 25FW ( 0.04) and ambulation distance during the 2MWT ( = 0.002). Statistically significant increases of SPPB total score ( = .04) and sub-scores were also found. Participants did not demonstrate significant changes in the MFIS ( = 0.31) or MSWS-12 ( = 0.06) after the intervention. Participants had a 58.3% adherence rate during the intervention and performed their exercise program an average of 2.5 times per week. All participants reported that they were either 'satisfied or 'very satisfied' with their telerehabilitation experience, would use telerehabilitation again, and would recommend telerehabilitation to others.
This individualized telerehabilitation intervention which integrates exergaming and clinical video teleconferencing is acceptable to patients and may offer a viable alternative to traditional PT for PwMS.
NCT03655431, retrospectively registered on August 31st, 2018.
物理康复服务是多发性硬化症患者（PwMS）治疗的重要组成部分，有助于改善和维持身体活动能力。然而，PwMS患者在接受门诊物理治疗（PT）服务时往往面临重大障碍，包括行动不便和缺乏交通工具。将运动游戏（exergaming）和远程医疗整合到临床PT实践中可能会克服这些障碍。这项试点研究的总体目的是评估使用exergaming的个性化远程PT干预的可接受性和效果。
10名多发性硬化症（MS）患者完成了为期12周的exergaming（Jintronix®）远程康复干预。为了衡量远程康复干预的可接受性，通过基于平板电脑的康复软件测量依从性，每位参与者完成一份满意度问卷。在基线和干预后评估临床结局指标。为了评估该干预的疗效，纳入了以下身体功能和疲劳测量指标：简短身体性能测试（SPPB）、25英尺步行测试（25FW）、改良疲劳影响量表（MFIS）、多发性硬化症步行量表-12（MSWS）和2分钟步行测试（2MWT）。使用符号检验和Wilcoxon符号秩检验分析临床结局。所有其他数据使用描述性统计进行评估。
干预后，参与者在25FW期间的步行速度（P = 0.04）和2MWT期间的步行距离（P = 0.002）有显著改善。还发现SPPB总分（P = 0.04）及其子分数有统计学意义的增加。干预后，参与者在MFIS（P = 0.31）或MSWS-12（P = 0.06）方面没有显著变化。参与者在干预期间的依从率为58.3%，平均每周进行2.5次锻炼计划。所有参与者报告他们对远程康复体验“满意”或“非常满意”，愿意再次使用远程康复，并会向他人推荐远程康复。
这种将exergaming和临床视频会议整合的个性化远程康复干预对患者来说是可以接受的，可能为PwMS患者提供一种替代传统PT的可行选择。
NCT03655431，于2018年8月31日进行回顾性注册。
