Patients with MS and significant mobility impairment require lifelong physical rehabilitation. The problem is that there can be many barriers limiting their ability to travel and participate in rehabilitation programs.
However, telemedicine has the potential to significantly improve access for MS patients to receive rehabilitation services but their efficacy has not yet been evaluated systematically.
The Department of Defense’s Congressionally Directed Medical Research Program (CDMRP) in April 2022, funded a pilot clinical trial to Dr. Joseph Finkelstein and Dr. Joel Stein at the Columbia University Medical Center.
The pilot trial is aiming to determine how physical telerehabilitation can affect functions and outcomes in MS patients with mobility impairment. The participants were randomly assigned to telerehabilitation and control groups.
The intervention group utilized the telerehabilitation system daily, while the control group received periodic newsletters. Patients were assessed at baseline, the end of a three month rehabilitation program, and at the six months follow up.
Overall, the results show that participation in a physical telerehabilitation program leads to significant improvements in disease-specific Quality of Life (QOL) which includes fatigue, balance, muscle resistance, and patient perceptions of the physical and psychological impact of MS. Since MS is a chronic neurodegenerative condition that currently has no cure, improvement in QOL is the major indicator of a successful intervention.
The study found that the intervention group showed improvement in many areas such as physical health, but the control group did not show improvements and in fact, many areas worsened in the control group. At a six month follow up, the intervention group demonstrated a statistically significant decrease in urgent care utilization as compared to the control group.
The researchers plan to conduct a phase III randomized clinical trial which will include a larger group of patients with MS representing a broader range of disability.