Telerehabilitation can be an effective complement to conventional rehabilitation in patients with Duchenne muscular dystrophy (DMD), according to a study recently published in Disability & Rehabilitation.
One of the clinical strategies to improve quality of life and extend life expectancy in DMD is physical rehabilitation. During the COVID-19 pandemic, access to medical facilities was severely restricted; doctors hence turned to telerehabilitation — the conducting of rehabilitation services through online video — to ensure that patients with DMD continued to receive care.
This approach has lasted beyond the pandemic because of the convenience it provides patients and the way it can improve exercise adherence. Nonetheless, because of its relatively novelty, the evidence for telerehabilitaiton is less well-established.
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Researchers hence conducted an analysis of existing studies on the use of telerehabilitation in DMD. They focused their search on high-quality studies that reported on patient outcomes. The final analysis included 14 studies, encompassing 356 patients with DMD. The telerehabilitation services provided mainly centered around physical exercise and respiratory rehabilitation delivered remotely via online platforms.
There were two kinds of programs on offer: “synchronous” interventions — real-time sessions conducted remotely — and “asynchronous” interventions, where participants performed movements that were not guided live. Examples of “asynchronous” interventions included home-based exercises, video-directed respiratory exercises and respiratory muscle training using special respiratory devices designed for patient home use. “Hybrid” interventions contained a mixture of both.
The majority of studies indicated that patients achieved meaningful improvements in muscle strength and mobility with telerehabilitation. Overall, studies also reported improvements in trunk control and functional performance. Several studies indicated that patients who received telerehabilitation recorded improvements across respiratory parameters.
Overall, patients were happy with telerehabilitation, but the specific benefits varied by program. While “synchronous” programs were associated with higher levels of patient satisfaction and adherence, “asynchronous” programs offered greater flexibility and accessibility.
The results of this study demonstrate that patients can achieve many of the same goals as set out by conventional rehabilitation; these include muscle strength improvement, the preservation of respiratory function, and continued engagement and adherence by the patients for whom this program was designed for. Furthermore, all these results were achievable without the hassle of traveling to a medical facility.
“Telerehabilitation is a feasible and safe adjunct to conventional rehabilitation in DMD,” the authors of the study concluded. “Evidence suggests it can improve motor function, respiratory outcomes, adherence and patient satisfaction, with synchronous interventions yielding the most consistent benefits.”
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