Feasibility of real-time internet-based teleconsultation in patients with multiple sclerosis: a pilot study (Preprint)

2020 ◽  
Author(s):  
Miguel D'Haeseleer ◽  
Piet Eelen ◽  
Nima Sadeghi ◽  
Marie Béatrice D'Hooghe ◽  
Jeroen Van Schependom ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Satisfaction ◽  
Pilot Study ◽  
Real Time ◽  
Neurological Disorders ◽  
The Internet ◽  
Technical Quality ◽  
Likert Scales ◽  
Technical Issues

BACKGROUND Telemedicine is currently flourishing in rural and emergency settings but its routine implementation in chronic neurological disorders develops more hesitatingly. OBJECTIVE To demonstrate the feasibility of planned real-time audiovisual teleconsultation over the internet in patients with multiple sclerosis (MS). METHODS Twenty subjects with MS presenting at a specialized MS center in Belgium were recruited for this study. One teleconsultation was scheduled in each participant. The approach was considered feasible if at least 80% of the planned visits could be completed at the foreseen moment. Patient satisfaction was evaluated by means of 5-point Likert scales containing the categories very unsatisfied, unsatisfied, neutral, satisfied and highly satisfied. RESULTS Seventeen out of twenty teleconsultations were successfully completed (85%). Failures were due to patients not responding (2/20) and technical issues (1/20). Rates of patients declaring themselves satisfied or highy satisfied were 17/17 for technical quality, 15/17 for convenience and 16/17 for overall quality of care. CONCLUSIONS Planned real-time audiovisual teleconsultation over the internet is feasibile and highly appreciated in patients with MS.

scholarly journals Feasibility of Real Time Internet-Based Teleconsultation in Patients With Multiple Sclerosis: Interventional Pilot Study

10.2196/18178 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18178
Author(s):  
Miguel D'Haeseleer ◽  
Piet Eelen ◽  
Nima Sadeghi ◽  
Marie B D'Hooghe ◽  
Jeroen Van Schependom ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Quality Of Care ◽  
Real Time ◽  
User Satisfaction ◽  
The Internet ◽  
Technical Quality ◽  
Care Providers ◽  
Care Facilities ◽  
Specialized Care

Background Telemedicine (TM) is currently flourishing in rural and emergency settings, but its implementation in the routine management of chronic neurological disorders has developed with more hesitation. Limited access to specialized care facilities and expanding patient populations, combined with unprecedented mobility restrictions imposed by the coronavirus disease pandemic, are currently stressing the need for remote solutions in this field. Studies in patients with multiple sclerosis (MS) have been heterogeneous in objectives and methodology but generally support the concept that TM interventions produce clinical benefits, cost-effectiveness, and user satisfaction. Nonetheless, data on live interaction between patients and health care providers for MS teleconsultation purposes remain scarce. Objective The aim of this study is to demonstrate the feasibility of planned real time audiovisual teleconsultation over the internet for patients with MS. Methods A total of 20 patients with MS presenting at a specialized MS center in Belgium were recruited for this study. One teleconsultation was scheduled for each participant. Patients were provided a unique hyperlink by mail in advance, leading them automatically and directly to the virtual waiting room, where they could accept or decline our incoming call. All teleconsultations were performed by a trained medical student with the intention to keep the conversation similar to what is usually discussed during a classic face-to-face MS consultation; no remote physical exams were performed. The approach was considered feasible if at least 80% of the planned TM visits could be successfully completed at the foreseen moment. Patient satisfaction (technical quality, convenience, and overall quality of care) was evaluated at the end of each teleconsultation by means of 5-point Likert scales containing the categories very unsatisfied, unsatisfied, neutral, satisfied, and highly satisfied. Results Out of 20 consultations, 17 were successfully completed (85%). Failures were due to patients not responding (n=2) and technical issues (n=1). Out of the 17 consultations, 17 patients declared themselves satisfied or highly satisfied for technical quality, 15 patients for convenience, and 16 patients for overall quality of care. Conclusions Planned real time audiovisual teleconsultation over the internet is feasible and highly appreciated in patients with MS. Incorporation of such services in routine clinical MS practice is expected to improve access to specialized care facilities for affected patients.

scholarly journals The Efficacy of Functional Electrical Stimulation of the Abdominal Muscles in the Treatment of Chronic Constipation in Patients with Multiple Sclerosis: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Christine Singleton ◽  
Abdel Magid Bakheit ◽  
Carla Peace
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Pilot Study ◽  
Transit Time ◽  
Functional Electrical Stimulation ◽  
Chronic Constipation ◽  
Abdominal Muscles ◽  
Related Quality

Chronic constipation in patients with multiple sclerosis (MS) is common and the current methods of treatment are ineffective in some patients. Anecdotal observations suggest that functional electrical stimulation (FES) of the abdominal muscles may be effective in the management of constipation in these patients.Patients and Methods. In this exploratory investigation we studied the effects of FES on the whole gut transit time (WGTT) and the colonic transit time (CTT). In addition, we evaluated the treatment effect on the patients’ constipation-related quality of life and on the use of laxatives and the use of manual bowel evacuation. FES was given for 30 minutes twice a day for a period of six weeks. Four female patients were studied.Results. The WGTT and CTT and constipation-related quality of life improved in all patients. The patients’ use of laxatives was reduced. No adverse effects of FES treatment were reported.Conclusion. The findings of this pilot study suggest that FES applied to the abdominal muscles may be an effective treatment modality for severe chronic constipation in patients with MS.

Patient Satisfaction With the Quality of Counseling Provided by Advanced Practice Nurses Specialized in Multiple Sclerosis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Melanie Weilenmann ◽  
Daniela Händler-Schuster ◽  
Heidi Petry ◽  
Diana Zanolari ◽  
Gabriela Schmid-Mohler ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Satisfaction ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses

The influence of cognitive impairment on health-related quality of life in neurological disease

2010 ◽  
Vol 22 (1) ◽  
pp. 2-13 ◽  
Author(s):  
Alex J. Mitchell ◽  
Steven Kemp ◽  
Julián Benito-León ◽  
Markus Reuber
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Neurological Disorders ◽  
Neurological Disease ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Mitchell AJ, Kemp S, Benito-León J, Reuber M. The influence of cognitive impairment on health-related quality of life in neurological disease.Background:Cognitive impairment is the most consistent neurological complication of acquired and degenerative brain disorders. Historically, most focus was on dementia but now has been broadened to include the important construct of mild cognitive impairment.Methods:Systematic search and review of articles linked quality of life (QoL) and cognitive complications of neurological disorders. We excluded QoL in dementia.Results:Our search identified 249 publications. Most research examined patients with brain tumours, stroke, epilepsy, head injury, Huntington's disease, motor neuron disease, multiple sclerosis and Parkinson's disease. Results suggested that the majority of patients with epilepsy, motor neuron disease, multiple sclerosis, Parkinson's disease, stroke and head injury have subtle cognitive deficits early in their disease course. These cognitive complaints are often overlooked by clinicians. In many cases, the cognitive impairment is progressive but it can also be relapsing-remitting and in some cases reversible. Despite the importance of severe cognitive impairment in the form of dementia, there is now increasing recognition of a broad spectrum of impairment, including those with subclinical or mild cognitive impairment. Even mild cognitive difficulties can have functional and psychiatric consequences–especially when they are persistent and untreated. Specific cognitive deficits such an inattention, dysexecutive function and processing speed may affect a number of quality of life (QoL) domains. For example, cognitive impairment influences return to work, interpersonal relationships and leisure activities. In addition, fear of future cognitive decline may also impact upon QoL.Conclusions:We recommend further development of simple tools to screen for cognitive impairments in each neurological condition. We also recommend that a thorough cognitive assessment should be a part of routine clinical practice in those caring for individuals with neurological disorders.

scholarly journals Telemedicine and Plastic Surgery: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Denis Souto Valente ◽  
Luciano Silveira Eifler ◽  
Lauro Aita Carvalho ◽  
Gustavo Azambuja Pereira Filho ◽  
Vinicius Weissheimer Ribeiro ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Real Time ◽  
Learning Experience ◽  
Medical Data ◽  
Descriptive Statistics ◽  
The Internet ◽  
Access To Education ◽  
Transmission Of Information ◽  
Quality Of Transmission

Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions.

Integrating Acupuncture Within a Wellness Intervention for Women With Multiple Sclerosis

2016 ◽  
Vol 35 (1) ◽  
pp. 86-96 ◽  
Author(s):  
Heather Becker ◽  
Alexa K. Stuifbergen ◽  
Rosa N. Schnyer ◽  
Janet D. Morrison ◽  
Ashley Henneghan
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Health Promotion ◽  
Pilot Study ◽  
Design Method ◽  
Holistic Health ◽  
Group Setting ◽  
Health Promoting Behaviors ◽  
Wellness Intervention

Purpose: This pilot study explored change over time in symptom management, health promotion, and quality of life following exposure to a holistic intervention combining group acupuncture with group sessions about health promotion for women with multiple sclerosis. Design: This was a pre/post nonexperimental design. Method: Fourteen women (average age 54 years) attended eight classes designed to help participants build the skills necessary to improve their health and consequently their overall quality of life. Acupuncture was provided in a group setting either immediately before or after each class. Findings: Self-reported fatigue, stress, pain, depression, anxiety, and sleep interference decreased significantly, and overall health-promoting behaviors, self-efficacy for health promotion, social functioning, and quality of life increased significantly. In addition, focus groups held with the participants indicated that they responded positively to the combination of acupuncture with an efficacy-building health promotion intervention. Conclusions: The results of this pilot study add to the growing literature demonstrating that holistic health promotion interventions may have positive benefits for people with multiple sclerosis. Delivering acupuncture to a small group of individuals attending wellness classes appears to be feasible and was generally well received by the study participants.

scholarly journals Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study (Preprint)

2020 ◽  
Author(s):  
Nils Cornelis ◽  
Roselien Buys ◽  
Tijl Dewit ◽  
Dries Benoit ◽  
Jomme Claes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Pilot Study ◽  
Exercise Training ◽  
Walking Distance ◽  
Elastic Band ◽  
Home Based ◽  
Walking Capacity ◽  
Resistance Exercises

BACKGROUND Current guidelines recommend supervised exercise training (SET) as a first-line treatment in patients with intermittent claudication (IC). SET has been shown to be more effective than home-based exercise therapy (HBET). However, the lack of available SET programs hampers broad SET implementation in clinical practice. OBJECTIVE The aim of this study is to assess patient satisfaction and acceptability of a structured HBET program using wearable technology and elastic band resistance exercises. METHODS A total of 20 patients with IC (Rutherford 1-3) with internet access and currently not engaged in structured exercise training were recruited in a pragmatic observational pilot study. Participants were instructed to complete 3 walking sessions and 2 elastic band resistance exercise sessions per week in their home environment during a 4-week period. Patient satisfaction and acceptability were assessed using a 5-point Likert scale questionnaire (1-2=very unsatisfied, 3=neutral, and 4-5=very satisfied) evaluating the materials and intervention content. Secondary outcomes were evaluated at baseline and at completion of the 4-week intervention and included maximal walking distance (MWD) and pain-free walking distance (PFWD), physical fitness, and patient-reported outcomes on quality of life, walking capacity, levels of kinesiophobia, and self-efficacy. Statistically significant changes were tested using paired <i>t</i> tests or Wilcoxon signed-rank tests. RESULTS All patients (15 men, 5 women; mean age 64.6, SD 10.6 years; range 41-81 years) completed the 4-week intervention and were highly satisfied with the program (mean overall score 4.5, SD 0.5). Patients’ questionnaire responses documented willingness to recommend the exercise program to other patients (mean 4.5, SD 0.5; median 4.5) and preference for continuing the intervention (mean 4.3, SD 0.5; median 4). Furthermore, participants endorsed the use of the sports watches to track walking sessions (mean 4.25, SD 0.6; median 4), felt safe (mean 4.4, SD 0.6; median 4), and appreciated personal feedback (mean 4.55, SD 0.5; median 5) and flexibility of training (mean 4.1, SD 0.7; median 4). Resistance training was not preferred over walking training (mean 2.65, SD 0.8; median 3). In addition, PFWD (+89 m; <i>P</i>=.001), MWD (+58 m; <i>P</i>=.03), Walking Impairment Questionnaire distance score (+0.18; <i>P</i>=.01), activity-related scores (+0.54; <i>P</i><.001), and total quality of life (+0.36; <i>P</i>=.009) improved following the intervention. Other patient-related outcomes, physical fitness, and physical activity remained to be statistically unaltered. CONCLUSIONS Patients with IC were satisfied and accepted technology to monitor and guide HBET, with observed short-term effectiveness regarding walking capacity and quality of life. However, elastic band resistance exercises as a part of HBET were not preferred over progressive walking. CLINICALTRIAL ClinicalTrials.gov NCT04043546; https://clinicaltrials.gov/ct2/show/NCT04043546

scholarly journals Feasibility of cognitive rehabilitation in patients with advanced multiple sclerosis: A pilot study

2021 ◽  
Vol 7 (4) ◽  
pp. 205521732110644
Author(s):  
Stefanos E Prouskas ◽  
Nancy D Chiaravalloti ◽  
Neeltje Kant ◽  
Karlene K Ball ◽  
Vincent de Groot ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Satisfaction ◽  
Pilot Study ◽  
Cognitive Rehabilitation ◽  
Energy Levels ◽  
Completion Rate ◽  
Adherence Rate ◽  
Completion Rates ◽  
And Training

Background The feasibility of cognitive rehabilitation is rarely investigated in patients with advanced multiple sclerosis. Methods Eighteen patients with advanced multiple sclerosis (median EDSS = 7.5) were randomized into restorative or compensatory cognitive rehabilitation. Feasibility was determined by adherence rate, completion rate, patient satisfaction, self-reported fatigue, training difficulty, and training duration. Results Adherence rates and completion rates were over 70%, and patients were highly satisfied in both groups. Energy levels decreased minimally during the sessions (pre = 6.9 vs post = 6.4). Training difficulty (4.6) and duration (5.7) were close to ideal (scale 1–10, 5 = ideal). Conclusions Cognitive rehabilitation, with minor adjustments, appears feasible in patients with advanced multiple sclerosis.

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