BACKGROUND: Telerehabilitation is a practical option for individuals with multiple sclerosis (MS) to engage in sustained physical activity without -visiting a rehabilitation facility. The aim of this systematic review was to evaluate the feasibility, effectiveness, safety, and adherence of exercise-based telerehabilitation as compared with usual care for MS patients. METHODS: A comprehensive literature search adhering to PRISMA guidelines was conducted, focusing on studies published in English since 2000. The systematic review protocol was registered in PROSPERO. The selection process involved strict criteria, including studies focusing on people with MS, telerehabilitation centred on regular exercise, a control group receiving usual care, valid exercise testing, and adherence to randomized controlled trial principles. Methodological quality was assessed using the TESTEX tool, ensuring rigour in study design and reporting. RESULTS: Among the 281 records screened, 10 studies met the criteria. Telerehabilitation interventions varied in format and outcomes were assessed using diverse exercise tests and questionnaires. Despite variations, the studies collectively demonstrated promising feasibility and safety, with minimal withdrawals and minor adverse events. Effectiveness varied, with 5 out of 10 studies showing significant improvements in the intervention group. Adherence rates ranged from 38% to 100%. CONCLUSION: In most of the assessed aspects, telerehabilitation is comparable to regular centre-based rehabilitation.
- MeSH
- adherence pacienta MeSH
- cvičení * MeSH
- lidé MeSH
- roztroušená skleróza * rehabilitace MeSH
- telerehabilitace * MeSH
- terapie cvičením * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
INTRODUCTION: Myotonic dystrophy type 2 (MD2) presents with a varied manifestation. Even though the myopathy in these patients is more widespread, axial musculature involvement is one of the most prominent conditions. MD2 patients also often report chronic low back pain (CLBP). The purpose of this study was to evaluate trunk muscle function, including respiratory muscles, in patients with MD2 and to compare it with healthy controls, to determine the occurrence of CLBP in patients with MD2, and to assess whether trunk muscle dysfunction increases the risk of CLBP in these patients. METHODS: We enrolled 40 MD2 patients (age range 23 to 76 years, 26 women). A comprehensive battery of tests was used to evaluate trunk muscle function. The tests consisted of quantitative muscle strength testing of low back extensor muscles and respiratory muscles and the assessment of trunk muscle endurance. A neurological evaluation contained procedures assessing the distribution of muscle weakness, myotonia, and pain, and used questionnaires focused on these items and on disability, depression, and physical activity. RESULTS: The results of this study suggest that patients with MD2 show significant dysfunction of the trunk muscles, including the respiratory muscles, expressed by decreased muscle strength and endurance. The prevalence of CLBP in patients with MD2 was 52.5%. Based on our analysis, the only independent significant risk factor for CLBP in these patients was maximal isometric lower back extensor strength in a prone position ≤ 15.8 kg (OR = 37.3). Other possible risk factors were severity of myotonia and reduced physical activity. CONCLUSION: Outcomes of this study highlighted the presence of axial muscle dysfunction, respiratory muscle weakness, and frequent occurrence of CLBP together with its risk factors in patients with MD2. We believe that the findings of this study may help in management and prevention programs for patients with MD2.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
INTRODUCTION: Alternatives such as remotely delivered therapy in the home environment or telehealth represent an opportunity to increase overall cardiac rehabilitation (CR) utilization. Implementing alternatives into regular practice is the next step in development; however, the cost aspect is essential for policymakers. Limited economic budgets lead to cost-effectiveness analyses before implementation. They are appropriate in cases where there is evidence that the compared intervention provides a similar health benefit to usual care. This systematic review aimed to compare the cost-effectiveness of exercise-based telehealth CR interventions compared to standard exercise-based CR. EVIDENCE ACQUISITION: PubMed and Web of Science databases were systematically searched up to August 2022 to identify randomized controlled trials assessing patients undergoing telehealth CR. The intervention was compared to standard CR protocols. The primary intent was to identify the cost-effectiveness. Interventions that met the criteria were home-based telehealth CR interventions delivered by information and communications technology (telephone, computer, internet, or videoconferencing) and included the results of an economic evaluation, comparing interventions in terms of cost-effectiveness, utility, costs and benefits, or cost-minimization analysis. The systematic review protocol was registered in the PROSPERO Registry (CRD42022322531). EVIDENCE SYNTHESIS: Out of 1525 identified studies, 67 articles were assessed for eligibility, and, at the end of the screening process, 12 studies were included in the present systematic review. Most studies (92%) included in this systematic review found strong evidence that exercise-based telehealth CR is cost-effective. Compared to CBCR, there were no major differences, except for three studies evaluating a significant difference in average cost per patient and intervention costs in favor of telehealth CR. CONCLUSIONS: Telehealth CR based on exercise is as cost-effective as CBCR interventions. Funding telehealth CR by third-party payers may promote patient participation to increase overall CR utilization. High-quality research is needed to identify the most cost-effective design.
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- analýza nákladů a výnosů MeSH
- cvičení MeSH
- kardiovaskulární rehabilitace * MeSH
- lidé MeSH
- telemedicína * MeSH
- telerehabilitace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
Home-based exercises have been on the rise recently. This pilot study aimed to assess the adherence and effect of a home-based rehabilitation programme using telemonitoring in patients with chronic non-specific low back pain (CNLBP). Twenty-seven patients with CNLBP were enrolled in the study, each of whom underwent a neurological assessment, including patient-oriented measures and a functional assessment-a battery of tests that comprehensively evaluated trunk muscle function. The rehabilitation programme lasted 18 weeks and included daily home-based exercises. A mobile application or an exercise diary was used to monitor compliance. Adherence to the programme was excellent for both the diary and mobile application groups, with 82.3% in the diary group exercising at least once a day and 72.9% twice a day, and 94.8% in the mobile application group exercising at least once a day and 86.6% twice a day. Both patient-oriented and functional outcomes improved significantly; however, the relative changes of the parameters in these two groups did not correlate, which supports the idea that trunk muscle function does not directly relate to patient complaints and that CNLBP is a multifactorial issue. This model of rehabilitation programme should be used in clinical practice, as its adherence and effectiveness seem noticeable.
- MeSH
- chronická bolest * MeSH
- fyzioterapie (techniky) MeSH
- lidé MeSH
- lumbalgie * rehabilitace MeSH
- pilotní projekty MeSH
- terapie cvičením MeSH
- trup MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Long-term physiotherapy is of considerable benefit to patients with multiple sclerosis (MS) who have motor dysfunction or gait impairment. The aim of this study was to determine the effectiveness of a 12-week intensive circuit class therapy for patients with MS, with a wider focus on fatigue and gait ability. METHODS: A total of 46 patients with relapsing-remitting MS were divided randomly into 2 groups: 23 patients (mean Expanded Disability Status Scale (EDSS) 2.33 ± 0.74) participated in an intensive 12-week course of intensive circuit class therapy, and 23 patients (mean EDSS 2.04 ± 0.63) served as a control group. The EDSS, Timed Up and Go (TUG) test and Four-Stage Balance Test (FSBT) made up the physical testing part, supplemented by questionnaires such as the Modified Fatigue Impact Scale (MFIS), 12-Item Multiple Sclerosis Walking Scale (MSWS-12), Beck Depression Inventory (BDI) and 36-Item Short Form Survey (SF-36). RESULTS: Significant improvements were found among intensive circuit class therapy-exercising patients in FSBT (p < 0.05), TUG test (p < 0.01), MFIS (p < 0.01), BDI (p < 0.05), MSWS-12 (p < 0.05) and the 3 subscales of SF-36 after 12 weeks of intensive circuit class therapy, while there were no significant changes in the control group. CONCLUSION: Intensive circuit class therapy is an effective therapeutic approach for improving gait and balance problems in patients with MS. It has also proved to alleviate fatigue and symptoms of depression.
Cíl: Potíže s chůzí jsou častým a závažným symptomem RS. Validovaný dotazník pro zhodnocení poruch chůze u pacientů s RS v českém jazykovém prostředí chybí. Cílem studie proto bylo vytvořit a validovat českou verzi dotazníku 12-Item Multiple Sclerosis Walking Scale (MSWS-12). Jedná se o jednoduchý anamnestický nástroj sestávající z 12 otázek. Materiál a metodika: Česká verze dotazníku MSWS-12 byla vytvořena metodou zpětného překladu a validována na souboru 50 pacientů s RS a 25 zdravých dobrovolníků. Dotazník byl administrován opakovaně s odstupem jednoho týdne za účelem hodnocení opakovatelnosti a reprodukovatelnosti. Chůze byla objektivně hodnocena pomocí testů Timed Up and Go (TUG) a Timed 25-Foot Walk (T25FW). Výsledky byly korelovány také s Expanded Disability Status Scale (EDSS) a Four-Stage Balance Test (FSBT). Výsledky: Skóre MSWS-12 dosáhlo u zdravých kontrol hodnot 12,4 ± 0,7 bodů. U pacientů s RS byly hodnoty významně vyšší (p < 0,001) a dosahovaly v průměru 24,0 ± 11,8 bodů. Hodnoty skóre MSWS-12 úzce korelovaly s objektivními testy chůze i disabilitou, tj. s TUG testem (r = 0,788; p < 0,001), T25FW testem (r = 0,878; p < 0,001), EDSS (r = 0,878; p < 0,001) i FSBT (r = 0,831; p < 0,001). Opakovatelnost MSWS-12 hodnocená pomocí Pearsonovy korelace byla vynikající (r = 0,96; p < 0,001). Hodnota Cronbachova alfa odrážející reprodukovatelnost dosáhla 0,983, což prokazuje vysokou vnitřní konzistenci dotazníku. Závěr: Česká verze dotazníku MSWS-12 prokázala velmi dobrou validitu v hodnocení poruch chůze u pacientů s RS a vynikající reprodukovatelnost a vnitřní konzistenci.
Aim: Walking difficulties are a common and serious symptom of MS. A validated questionnaire for the evaluation of gait disorders in patients with MS in the Czech language is missing. The aim of this study was to create and validate the Czech version of the 12-Item Multiple Sclerosis Walking Scale (MSWS-12) questionnaire, a simple anamnestic tool consisting of 12 questions. Materials and methods: The Czech version of the MSWS-12 questionnaire was created by the forward-backward translation method and validated in 50 MS patients and 25 healthy volunteers. The questionnaire was administered repeatedly one week apart to assess repeatability and reproducibility. Walking was objectively assessed using the Timed Up and Go (TUG) test and the 25 Foot Walk (T25FW) test. The results were correlated also with the Expanded Disability Status Scale (EDSS) and the Four-Stage Balance Test (FSBT). Results: Healthy controls scored 12.4 ± 0.7 points in the MSWS-12. In patients with MS, the values were significantly higher (P < 0.001) and reached 24.0 ± 11.8 points in average. The MSWS-12 score values closely correlated with walking tests and level of disability. i.e., the TUG test (r = 0.788; P < 0.001), T25FW test (r = 0.878; P < 0.001), EDSS (r = 0.878; P < 0.001), and FSBT (r = 0.831; P < 0.001). The repeatability assessed by Pearson´s correlation was 0.96 (P < 0.001). The reproducibility value of Cronbach’s alpha reached 0.983, which demonstrates the high internal consistency of the questionnaire. Conclusion: The Czech version of the MSWS-12 questionnaire showed very good validity in the evaluation of gait disorders in MS patients, and excellent reproducibility and internal consistency.
- MeSH
- lidé MeSH
- neurologické poruchy chůze * MeSH
- průzkumy a dotazníky MeSH
- reprodukovatelnost výsledků MeSH
- roztroušená skleróza * komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
