Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study

Paul, L., Renfrew, L., Freeman, J., Murray, H., Weller, B., Mattison, P., McConnachie, A. , Heggie, R., Wu, O. and Coulter, E. H. (2019) Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study. Clinical Rehabilitation, 33(3), pp. 473-484. (doi: 10.1177/0269215518817080) (PMID:30514108)

Abstract

Objective: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis. Design: Multi-centre, randomized controlled, feasibility study. Setting: Three multiple sclerosis out-patient centres. Participants: A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4–6.5). Interventions: Participants were randomized to a six-month individualized, home exercise programme delivered via web-based physiotherapy (n = 45; intervention) or a sheet of exercises (n = 45; active comparator). Outcome measures: Outcome measures (0, three, six and nine months) included adherence, two-minute walk test, 25 foot walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists. Results: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40%–63% and 53%–71% in the intervention and comparator groups. There was no difference in the two-minute walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at six-month Intervention-81.6(32.75)m, Comparator-74.8(36.16)m. There were no significant changes over time in other outcome measures except the EuroQol-5 Dimension at six months which decreased in the active comparator group. For a difference of 8(17.4)m in two-minute walk test between groups, 76 participants/group would be required (80% power, P > 0.05) for a future randomized controlled trial. Conclusion: No changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.

• Item Type: Articles
• Additional Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Multiple Sclerosis Society, UK (Grant Ref 11).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Coulter, Dr Elaine and Paul, Dr Lorna and Heggie, Mr Robert and Murray, Mrs Heather and Wu, Professor Olivia and McConnachie, Professor Alex
• Authors: Paul, L., Renfrew, L., Freeman, J., Murray, H., Weller, B., Mattison, P., McConnachie, A., Heggie, R., Wu, O., and Coulter, E. H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: Clinical Rehabilitation
• Publisher: SAGE
• ISSN: 0269-2155
• ISSN (Online): 1477-0873
• Published Online: 04 December 2018
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in Clinical Rehabilitation 33(3):473-484
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher