Under & Over: A randomised controlled study to develop an upper limb rehabilitation tool for people with Multiple Sclerosis.

Multiple sclerosis Rehabilitation Upper limb

Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
01 Mar 2024
Historique:
received: 22 11 2023
revised: 24 01 2024
accepted: 27 02 2024
medline: 7 3 2024
pubmed: 7 3 2024
entrez: 6 3 2024
Statut: aheadofprint

Résumé

Impairment of upper limb function is common in Multiple Sclerosis (MS). Rehabilitation remains a key strategy to manage symptoms and improve quality of life. The Under & Over study assessed the effectiveness of a rehabilitation programme in people with advanced MS. To determine if repeated use of Under & Over can improve upper limb function for people with MS. One hundred and six (N = 106) people with MS participated in this 3-month study. The primary outcome measure was the cardboard 9-hole peg test (c9HPT), with secondary outcomes including the EuroQol-5Dimensions, 5-Level Questionnaire (EQ5D-5 L) questionnaire. There were three arms: Arm 1a, the 'Daily Group', engaged with the Under & Over tool daily for 30 min. Arm 1b, the 'Free Use Group', used the same tool without time constraints, with the added feature of a community sharing platform. Arm 2, the 'Delayed Start Group', initially completed the c9HPT for three months before switching to the 'Free Use' programme. 43/106 (41 %) of those randomised completed the primary end point. No significant difference between c9HPT at baseline and 3 months was seen in Arm 1a or 1b. Participants in Arm 2 who had been completing the c9HPT 5 days a week for 3 months showed a training effect in the dominant hand (mean speed at baseline 0.0455 (s This study demonstrates how a small, engaged, and motivated group were able to complete a remote rehabilitation programme. Future remote intervention studies could benefit from incorporating adaptive engagement strategies, such as personalised reminders and participant-tailored activity adjustments, to enhance adherence and capture a broader spectrum of patient experiences.

Sections du résumé

BACKGROUND BACKGROUND
Impairment of upper limb function is common in Multiple Sclerosis (MS). Rehabilitation remains a key strategy to manage symptoms and improve quality of life. The Under & Over study assessed the effectiveness of a rehabilitation programme in people with advanced MS.
OBJECTIVE OBJECTIVE
To determine if repeated use of Under & Over can improve upper limb function for people with MS.
METHODS METHODS
One hundred and six (N = 106) people with MS participated in this 3-month study. The primary outcome measure was the cardboard 9-hole peg test (c9HPT), with secondary outcomes including the EuroQol-5Dimensions, 5-Level Questionnaire (EQ5D-5 L) questionnaire. There were three arms: Arm 1a, the 'Daily Group', engaged with the Under & Over tool daily for 30 min. Arm 1b, the 'Free Use Group', used the same tool without time constraints, with the added feature of a community sharing platform. Arm 2, the 'Delayed Start Group', initially completed the c9HPT for three months before switching to the 'Free Use' programme.
RESULTS RESULTS
43/106 (41 %) of those randomised completed the primary end point. No significant difference between c9HPT at baseline and 3 months was seen in Arm 1a or 1b. Participants in Arm 2 who had been completing the c9HPT 5 days a week for 3 months showed a training effect in the dominant hand (mean speed at baseline 0.0455 (s
CONCLUSIONS CONCLUSIONS
This study demonstrates how a small, engaged, and motivated group were able to complete a remote rehabilitation programme. Future remote intervention studies could benefit from incorporating adaptive engagement strategies, such as personalised reminders and participant-tailored activity adjustments, to enhance adherence and capture a broader spectrum of patient experiences.

Identifiants

pubmed: 38447394
pii: S2211-0348(24)00108-1
doi: 10.1016/j.msard.2024.105529
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105529

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The Author(s) declare(s) that there is no conflict of interest.

Auteurs

Alison Thomson (A)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK. Electronic address: a.thomson@qmul.ac.uk.

Andrea Stennett (A)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

Canan Metin (C)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

Jonathan Bestwick (J)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

Gavin Giovannoni (G)

Blizard Institute, Queen Mary University of London, London, UK.

Ruth Dobson (R)

Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

Classifications MeSH