Telecommunication and rehabilitation for patients with multiple sclerosis. Access and willingness to use: a cross-sectional study.

Remy, Caroline;Valet, Maxime;Stoquart, Gaëtan;El Sankari, Souraya;Lejeune, Thierry;et.al.
(2020) European Journal of Physical and Rehabilitation Medicine : a journal of physical medicine and rehabilitation after pathological events — Vol. 56, n° 4, p. 403-411 (2020)

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Abstract
(en) BACKGROUND: Telerehabilitation is a promising approach for patients with multiple sclerosis (MS), but uncertainties regarding patients' access and preferences remain. AIM: To investigate the access to telecommunication technologies and rehabilitation services of patients with MS, and their willingness to use these technologies for rehabilitation. DESIGN: Cross-sectional survey. SETTING: Outpatient neurological facility. POPULATION: Patients with MS. METHODS: Patients with MS attending consultations in the Neurology department were asked to fill in a paper questionnaire. This anonymous z was designed to gain information about needs and access to rehabilitation and telecommunication technologies, as well as interests and perspectives of telerehabilitation among these patients. Descriptive statistics, Chi-squared tests and logistic regressions were used to describe the sample and survey answers. RESULTS: Two hundred patients completed the questionnaire. Mean age was 44.41(±12.52) years. Seventy-one percent were women, and 49% were unemployed. Ninety-one percent of the patients regularly used internet and 73% used apps. Most patients were interested in using telecommunication technologies to receive a program of physical exercises (62%), for information and personalized advice about physical activity and MS (69%), and to communicate with caregivers (75%). Patients with EDSS>4 were less interested than patients with EDSS≤4 in communicating with the caregivers via apps (33% vs. 52%,Δ19%[CI-36%;-2%],P=0.04) but expressed greater interest in receiving information and personal advice about physical activity and MS via the internet (70% vs. 51%,Δ19%[CI+2%;+36%],P=0.03). One third of the patients was not interested in receiving telerehabilitation interventions (32%), notably patients with EDSS>4 and non-workers. CONCLUSIONS: Patients with MS are mainly interested in using telecommunication technologies for rehabilitation services, and most of these patients have access to the required technology. Being mildly disabled and having a professional activity are associated with a greater interest in telerehabilitation. In contrary, patients with moderate-to-severe disability and non-workers have reportedly less access and ease in using the required technologies. Clinical rehabilitation impact: Telerehabilitation is feasible and wished by patients with MS, specifically in patients with low EDSS scores and workers. Given the strong need for rehabilitation in more disabled patients, the barriers to its access, the lower access and ease of use of telecommunication technologies, a special effort is needed to facilitate their use in these patients.
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Remy, C., Valet, M., Stoquart, G., El Sankari, S., Van Pesch, V., De Haan, A., & Lejeune, T. (2020). Telecommunication and rehabilitation for patients with multiple sclerosis. Access and willingness to use: a cross-sectional study. European Journal of Physical and Rehabilitation Medicine : a journal of physical medicine and rehabilitation after pathological events, 56(4), 403-411. https://doi.org/10.23736/S1973-9087.20.06061-X (Original work published 2020)