Fiona Doherty

Current Research Masters Student

Research Project Summary:

Rehabilitation is recognised as the gold standard method to manage/improve both physical and cognitive impairments in patients with multiple sclerosis. Some of the common rehabilitation techniques used include: physical therapy, exercise training and gait training for physical impairment (Baird et al., 2018) cognitive dysfunction: a combination approach method may be used, for instance a modified story memory technique, self-generation method and a spaced retrieval technique (Longley, 2022). Thes rehabilitation techniques are usually managed in a face-to-face clinic setting, however some of these techniques are currently being carried out remotely. Emerging evidence in the literature is suggesting that patients with MS may be able to be treated with rehab remotely and a recent comprehensive literature review concluded that telerehabilitation is beneficial, cost-effective and satisfying for people with MS (Van Laethem et al., 2022). The potential benefits of remote therapy have been highlighted by Shaw et al (2019), and these include; reduces the burden of outpatient clinic visits which can be high for people with families, work commitments and who have physical/cognitive disabilities, reduces the cost of travelling to appointments, allows access and inclusivity to a greater range of people with varying levels of disabilities such as patients who live in out of reach areas. According to Prvu Bettger and Resnik (2020), telerehabilitation for MS increases treatment adherence which optimises clinical benefit for MS patients. As an example, a recent US study (Sebastião et al., 2018) of 26 older MS patients with mild-to-moderate levels of disability who were given a 12-week home-based square stepping exercise program (SSE) compared with a control of minimal exercise. The SSE group received a mat, an instruction manual and a logbook along with a pedometer to monitor compliance. Weekly skype calls were received by both groups with bi-weekly meetings with an exercise trainer. The objective of SSE intervention was to improve common dysfunctions of older adults with MS such as walking, balance and cognition and overall the effect sizes (Cohens, d) ranged from small to moderate with no adverse effects observed (e.g., MS related symptoms. relapses). Good compliance was also observed which was demonstrated by the pedometer data. The results concluded that the SSE invention has great potential for improving physical and cognitive functions. The results also support the theory that telerehabilitation is highly beneficial with high treatment adherence and satisfactory to MS patients.

From reading the above we can conclude that MS patients need rehabilitation therapies and there appears to be a potential for rehabilitation to be given in some remote fashion. There is a need to explore the following: –

What telerehabilitation treatments are currently being used for MS patients?

Do these treatments work and could a systematic literature review assess this?

Is there a need for an online rehab platform to be developed that could incorporate some of these therapies?

If this online rehab platform was being developed, what areas would it address to make it as effective/beneficial as it can be?

This research project will discuss some of these issues above which could be incorporated into a potential Online Platform for MS patients in the future.

Bio:

I graduated from ATU, Sligo in 2022 with a 1st class honours degree in Public Health and Health Promotion. In 2021. In 2021, I obtained a certificate from ATU, Sligo in Health Data Analytics where I developed skills in decision analytical modelling and health data statistics. In 2011, I completed a BSc in pharmaceutical science at ATU, Sligo.

While studying for the Public Health and Health Promotion degree I developed a passion and curiosity for global health and well-being issues and during my placement I got the opportunity to create resources for health practitioners and parents/caregivers: the impact adverse childhood experiences have on health and well-being. over the duration of a life span.

I gravitated towards the research masters in the neuroplasticity research group department as they are a community of like-minded people who are striving tirelessly to improve the quality of life of patients with neurological disorders which will have a significant impact on their mental health and well-being. I very much look forward to working with a diverse group of people who are leading the way in developing a remote physical rehabilitation platform which has the potential to be used in patient care pathways in the future.

Papers

“Physical Telerehabilitation Interventions for Gait and Balance function in People with Multiple Sclerosis: A Scoping Review” (completed June 2023)

Collaborations

Neurology Support Centre, Sligo