TY - JOUR
T1 - Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: a systematic review
AU - Amatya, Bhasker
AU - Galea, Mary Pauline
AU - Kesselring, Jurg
AU - Khan, Farees
PY - 2015
Y1 - 2015
N2 - Background Telerehabilitation, a service delivery model using telecommunications technology to provide therapy at a distance, is used in persons with multiple sclerosis (pwMS), but evidence for their effectiveness is yet to be determined. Objective To investigate the effectiveness and safety of telerehabilitation intervention pwMS. Method A comprehensive literature search was conducted using medical and health science electronic databases. Three reviewers selected potential studies and independently assessed the methodological quality. A meta-analysis was not possible due to heterogeneity amongst included trials, and a qualitative analysis was performed for best evidence synthesis. Results Ten RCTs and 2 observational studies (n=564 participants) investigated a wide variety of telerehabilitation intervention in pwMS, which included: physical activity; educational, behavioural and symptom management programmes. All studies scored low to moderate on the methodological quality assessment implying high risk of bias. Overall, the review found low level evidence for the effectiveness of telerehabilitation on reducing short-term disability and reducing and/or improving symptoms, such as fatigue. There was low level evidence suggesting some benefit of telerehabilitation in improving functional activities; improving symptoms in the longer-term; and psychological outcomes and quality of life. There is limited data on safety, process evaluation and no data on cost-effectiveness of telerehabilitation. Conclusions A wide range of telerehabilitation is used in pwMS, however, the quality of evidence on these interventions was low. More robust trials are needed to build evidence about these interventions. ? 2015 Elsevier B.V.
AB - Background Telerehabilitation, a service delivery model using telecommunications technology to provide therapy at a distance, is used in persons with multiple sclerosis (pwMS), but evidence for their effectiveness is yet to be determined. Objective To investigate the effectiveness and safety of telerehabilitation intervention pwMS. Method A comprehensive literature search was conducted using medical and health science electronic databases. Three reviewers selected potential studies and independently assessed the methodological quality. A meta-analysis was not possible due to heterogeneity amongst included trials, and a qualitative analysis was performed for best evidence synthesis. Results Ten RCTs and 2 observational studies (n=564 participants) investigated a wide variety of telerehabilitation intervention in pwMS, which included: physical activity; educational, behavioural and symptom management programmes. All studies scored low to moderate on the methodological quality assessment implying high risk of bias. Overall, the review found low level evidence for the effectiveness of telerehabilitation on reducing short-term disability and reducing and/or improving symptoms, such as fatigue. There was low level evidence suggesting some benefit of telerehabilitation in improving functional activities; improving symptoms in the longer-term; and psychological outcomes and quality of life. There is limited data on safety, process evaluation and no data on cost-effectiveness of telerehabilitation. Conclusions A wide range of telerehabilitation is used in pwMS, however, the quality of evidence on these interventions was low. More robust trials are needed to build evidence about these interventions. ? 2015 Elsevier B.V.
UR - http://www.sciencedirect.com/science/article/pii/S2211034815000826
U2 - 10.1016/j.msard.2015.06.011
DO - 10.1016/j.msard.2015.06.011
M3 - Article
SN - 2211-0348
VL - 4
SP - 358
EP - 369
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
IS - 4
ER -