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远程医疗在多发性硬化症患者疲劳管理中的应用:一项范围综述。

Application of telemedicine in fatigue management for patients with multiple sclerosis: A scoping review.

作者信息

Gong Xiaoyan, Xue Xiaoyu, Gao Rong, Feng Shengya, Ji Xinyu, Zheng Jie, Xue Bowen

机构信息

School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China.

Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, China.

出版信息

PLoS One. 2025 Jul 17;20(7):e0327563. doi: 10.1371/journal.pone.0327563. eCollection 2025.

Abstract

BACKGROUND

Fatigue is a prevalent symptom in people with Multiple Sclerosis, but evidence for the effectiveness of telemedicine in treating this symptom remains incomplete. Despite favorable clinical trial results, its integration into practice and systematic evaluation is limited.

OBJECTIVE

The purpose of this research project is to carefully assess how well telemedicine works for managing fatigue in MS patients.

METHODS

This scoping review adhered to the Joanna Briggs Institute methodological framework and followed the preferred reporting items for systematic reviews and meta-Analyses extension for ccoping reviews (PRISMA-ScR) guidelines. reporting guidelines. A search covering literature in both English and Chinese up until December 2024 was carried out in the electronic databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP database. Studies that assessed telemedicine-based therapies for patients with multiple sclerosis and documented fatigue-related outcomes were eligible. The collected literature was compiled, examined, and pertinent information was extracted by two independent reviewers.

RESULTS

A total of 26 papers were included, all in English. Applications(n = 11), wearable devices(n = 8), teleconferences(n = 11), online platforms(n = 5), text messaging(n = 1), virtual reality(n = 1), and game consoles(n = 1) are some of the intervention forms of telemedicine. Remote monitoring(100% of studies), remote guidance(54%), and remote rehabilitation(58%) are some of the functional characteristics of telemedicine. Fatigue characteristics and its impact, health-related quality of life, physical activity, mental health, and the feasibility of remote interventions are among the outcome indicators. While 77% of studies reported statistically significant fatigue reduction, effect sizes varied from small to moderate.

CONCLUSION

Telemedicine demonstrates potential as a viable alternative to conventional rehabilitation for managing MS-related fatigue, particularly through multimodal interventions enabling personalized and real-time management. However, the heterogeneity in influencing factors and treatment effects warrants validation through large-scale trials. Future research should prioritize multimodal strategies, optimizing sample composition, extending follow-up periods, and integrating standardized assessment tools to enhance intervention precision.

摘要

背景

疲劳是多发性硬化症患者中普遍存在的症状,但远程医疗治疗该症状有效性的证据仍不完整。尽管临床试验结果良好,但其在实践中的整合及系统评估有限。

目的

本研究项目旨在仔细评估远程医疗对多发性硬化症患者疲劳管理的效果。

方法

本范围综述遵循乔安娜·布里格斯研究所的方法框架,并遵循系统评价和Meta分析扩展版的范围综述(PRISMA-ScR)报告指南。在PubMed、Embase、Web of Science、CINAHL、Cochrane图书馆、中国知网(CNKI)、万方和维普数据库等电子数据库中进行了检索,涵盖截至2024年12月的中英文文献。评估针对多发性硬化症患者的基于远程医疗的疗法并记录与疲劳相关结果的研究符合纳入标准。由两名独立评审员对收集到的文献进行整理、审查并提取相关信息。

结果

共纳入26篇论文,均为英文。远程医疗的干预形式包括应用程序(n = 11)、可穿戴设备(n = 8)、电话会议(n = 11)、在线平台(n = 5)、短信(n = 1)、虚拟现实(n = 1)和游戏机(n = 1)。远程监测(100%的研究)、远程指导(54%)和远程康复(58%)是远程医疗的一些功能特点。结果指标包括疲劳特征及其影响、健康相关生活质量、身体活动、心理健康以及远程干预的可行性。虽然77%的研究报告疲劳程度有统计学意义的降低,但效应大小从小到中等不等。

结论

远程医疗显示出作为管理与多发性硬化症相关疲劳的传统康复方法的可行替代方案的潜力,特别是通过多模式干预实现个性化和实时管理。然而,影响因素和治疗效果的异质性需要通过大规模试验进行验证。未来的研究应优先考虑多模式策略,优化样本构成,延长随访期,并整合标准化评估工具以提高干预精度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2de/12270147/ba25f83d4491/pone.0327563.g001.jpg

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