Utilizing Technology to Improve Patient Adherence and Professional Patient Monitoring for at-Home Exercise Programs in Patients with Multiple Sclerosis
Multiple Sclerosis (MS) is a degenerative neurological disorder that can present with a wide range of motor, sensory, and cognitive dysfunction, with significant symptom variance amongst individual patients. Patients are frequently confronted with many hurdles such as transportation issues and long distances to MS specialists, which make it difficult for patients to receive the highest quality treatment and consistent monitoring. Although no cure has been identified for MS, exercise and physical rehabilitation programs have exhibited positive outcomes in patients’ quality of life, fatigue, motor function, and overall well being. However, adherence with any rehabilitative program or exercise routine has often been very low, and is a limiting factor in maximizing the positive benefits of an appropriate exercise program. The use of technology could provide a method for improving patient compliance, while providing therapy to patients who would not otherwise be able to receive it.
This study proposes a protocol for a remote monitored tele-rehabilitation program for patients with Multiple Sclerosis. The study examines the effectiveness of technology, including the iPad and Fitbit exercise tracker, on improving overall physician-patient communication, access to physical therapy programs, as well as patient compliance with prescribed rehabilitation programs.
The 8 patients selected for this case series, met all inclusion and exclusion criteria, and presented with disease symptoms uniquely different from each other. Patients completed an in-person comprehensive initial consultation including: physical examination; baseline functional assessment via Tinetti balance assessment, timed 25ft walk, and timed up and go test; as well as technical instruction on iPad Facetime and Fitbit exercise tracker. Each patient was provided with an at home exercise program, consisting of 8-10 exercises tailored towards their needs. Patients were instructed to wear their Fitbit everyday and perform their rehab program 5 to all days. Patients also kept an exercise diary, noting the date and time of their exercises, as well any concerns or difficulties. Each patient follow ups were performed via FaceTime video call every 2-3 weeks to assess progress and discuss any necessary changes. Following completion of the 12-week program, all patients returned to clinic for reassessment of baseline functional tests, and completion of a post-study questionnaire.
The utilization of iPad and Fitbit technology proved to be an effective method of conducting a remote monitored tele-rehabilitation program for patients with Multiple Sclerosis. FaceTime video calls and Fitbit exercise trackers improved patient compliance with at home rehab programs, as well as patient-physician communication.