Web-based Physiotherapy for people affected by Multiple Sclerosis (WEBPaMS): a pragmatic, single blind, randomised controlled feasibility study

Objective: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with Multiple Sclerosis (MS). Design: Multi-centre, randomised controlled, feasibility study Setting: Three Multiple Sclerosis out-patient centres Participants: Ninety people with Multiple Sclerosis (Expanded Disability Disease Scale 4-6.5) Interventions: Participants were randomised, to a 6 month individualised, home exercise programme delivered via web-based physiotherapy (n=45) (intervention) or a sheet of exercises (n=45) (active comparator). Main outcome measures: Outcome measures (0, 3, 6 and 9 months) included adherence, 2min walk test, 25ft walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists. Results: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40-63% and 53-71% in the web-based physiotherapy and comparator groups. There was no difference in the 2min walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at 6 months Intervention-81.6(32.75)m, Comparator 74.8(36.16)m). There were no significant changes over time in other outcome measures except the EQ-5D at 6 months which improved in the active comparator group. For a difference of 8(17.4)m in the 45 2min walk test between groups 76 participants/group would be required (80% power, p>0.05) for a future randomised controlled trial. Conclusion: no changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.