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

Area of Science:

• Neurology
• Rehabilitation Science
• Clinical Trials

Background:

• Upper limb function impairment is a common challenge for individuals with Multiple Sclerosis (MS).
• Rehabilitation programs are crucial for managing MS symptoms and enhancing patient quality of life.
• The Under & Over study investigated a novel rehabilitation program for advanced MS.

Purpose of the Study:

• To evaluate the effectiveness of the Under & Over rehabilitation program for improving upper limb function in Multiple Sclerosis patients.
• To assess the impact of repeated use of the Under & Over tool on functional outcomes in MS.

Main Methods:

• A 3-month study involving 106 individuals with MS.
• Primary outcome measured by the cardboard 9-hole peg test (c9HPT).
• Three arms: daily use (30 min), free use with community platform, and delayed start.
• Secondary outcomes included the EuroQol-5Dimensions, 5-Level Questionnaire (EQ5D-5 L).

Main Results:

• Only 41% of participants completed the study.
• No significant improvement in c9HPT scores was observed in the daily or free use groups.
• A training effect was noted in the delayed start group on their dominant hand's c9HPT performance.
• Participant adherence was a significant limitation, impacting the study's power.

Conclusions:

• Remote rehabilitation programs can be completed by small, motivated groups of MS patients.
• Future remote interventions should incorporate adaptive strategies like personalized reminders to improve adherence.
• Tailored activity adjustments are recommended to enhance engagement and capture diverse patient experiences in MS rehabilitation.