Integrated telerehabilitation approach eases motor symptoms in multiple sclerosis

An integrated telerehabilitation approach (ITA) confers benefits to individuals with multiple sclerosis (MS) in the treatment of motor symptoms according to the current model of continuity of care, reports a recent study.

“However, the low efficacy of ITA on cognition and participation domains suggests the necessity to develop intervention models that include a broader spectrum of needs and objectives,” the investigators said.

A systematic search was performed for original manuscripts focusing on ITA in MS patients. Efficacy on motor, cognitive, and participation outcomes were measured as the standardized mean difference (Hedges’ g) of pre- and post-training.

Nine studies, including a total of 716 MS patients, met the eligibility criteria. The overall effect of ITA was large for motor outcomes (g, 1.05; p=0.013), small for cognitive performance outcomes (g, 0.16; p=0.237), and small for participation outcomes (g, 0.15; p=0.259).

Domain-specific results demonstrated large effect on motor disability (g, 1.18) and medium effect on gait (g, 0.32) and balance (g, 0.48). In addition, all effects on single cognitive domains were small. Among the single participation outcomes considered (ie, depression fatigue, daily functioning, quality of life, and self-efficacy), only depression had a nearly medium effect (g, 0.30).

“MS is a chronic immune-mediated disease of the central nervous system and a major cause of disability in young adults,” the investigators said. “Recently, there has been a growing interest in the development of innovative ways to deliver rehabilitation care outside of a hospital setting.”