Abstract Details

Title Upper Extremity Telerehabilitation for Progressive Multiple Sclerosis

Topic Neuro-rehabilitation

Presentation(s) P7 - Poster Session 7 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-005

Objective To determine the feasibility of an upper extremity motor telerehabilitation program delivered at home for people with progressive multiple sclerosis (MS).

Background Patients with progressive MS are typically older and with more advanced disability, representing an underserved patient population often considered to be less responsive to rehabilitative efforts. Manual dexterity is commonly affected, and limited hand use can lead to reduced quality of life. Rehabilitative exercises can improve function and delay decline. However, travel to clinic for repeated rehabilitation appointments can impose a barrier to access. Here, we tested the feasibility of an at-home manual dexterity training program delivered and monitored in real time via videoconference.

Design/Methods Participants were recruited through the NYU Langone MS Care Center as part of an ongoing study of transcranial direct current stimulation (tDCS) to enhance training outcomes. At study entry, they completed clinical assessments, were trained on study procedures, and provided with training materials for exercises to address hand dexterity. Then, the participants were scheduled to complete 20 daily sessions over four weeks, where they trained for 30 minutes supervised remotely by a staff member who directed and timed their exercises.

Results We have enrolled 36 participants: median EDSS 6.0 (range 2.0 to 7.5), age=55.2 (range 37 to 70 years). Two participants discontinued, and 34 completed an average of 19.6 sessions, demonstrating 98.1% adherence. Adherence rates were high even for those with advanced disability (n=14, EDSS >6.0, 99.6%), cognitive impairment (SDMT <-1.5, n=12, 99.6%), and older age (n=5≥ 65 years, 99.0%).

Conclusions A program of daily manual dexterity training delivered at home via telerehabilitation is feasible for individuals with progressive MS despite advanced disability, cognitive impairment and older age. A telerehabilitation platform increases access, promotes adherence to therapy, and may be used to preserve function in this population.

Authors/Disclosures
Martin Malik PRESENTER	Martin Malik has nothing to disclose.
Matthew Lustberg	No disclosure on file
Ashwin Kumar	No disclosure on file
Lauren B. Krupp, MD, F�鶹��ýӳ�� (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
Kathleen Sherman (NYU Langone Health, MS Comprehensive Care Center)	An immediate family member of Ms. Sherman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Total Solutions. An immediate family member of Ms. Sherman has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for APA.
	No disclosure on file
	No disclosure on file
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.

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