PDF(Pubmed)
Abstract：
UNASSIGNED: Vertigo, dizziness, gaze instability and disequilibrium are highly prevalent in people with MS (PwMS) and head movement induced dizziness is commonly reported. Vestibular physical therapy (VPT) is a specialised, non-invasive and effective therapy for these problems but usually involves travel for the person to a specialist center with both personal and carbon costs. The use of wearable sensors to track head movement and smartphone applications to deliver and track programs has potential to improve VPT in MS.
UNASSIGNED: This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise.
UNASSIGNED: Sixteen PwMS (14 female), mean age 44(±14) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (±18.4). SUS scores were high at 81 (±14) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; p = 0.004), mDGI (median change 1.00; p = 0.008), DVA (median change -1.00; p = 0.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; p < 0.05). Non-significant improvements were seen in DHI (p = 0.07) and GS (p = 0.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system.
UNASSIGNED: This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.
UNASSIGNED: This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise.
UNASSIGNED: Sixteen PwMS (14 female), mean age 44(±14) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (±18.4). SUS scores were high at 81 (±14) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; p = 0.004), mDGI (median change 1.00; p = 0.008), DVA (median change -1.00; p = 0.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; p < 0.05). Non-significant improvements were seen in DHI (p = 0.07) and GS (p = 0.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system.
UNASSIGNED: This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.
摘要：
■眩晕，头晕,凝视不稳定和不平衡在MS（PwMS）患者中非常普遍，并且通常报道头部运动引起的头晕。前庭物理疗法（VPT）是一种专门的，这些问题的非侵入性和有效的治疗方法，但通常涉及到个人和碳成本的专家中心。使用可穿戴传感器跟踪头部运动和智能手机应用程序来交付和跟踪程序有可能改善MS的VPT。
■本研究调查了商用数字VPT系统（可穿戴式头部传感器，智能手机应用程序和临床医生软件)向PwMS提供VPT。采用治疗前/后设计，主要结果是系统可用性量表（SUS）。其他患者报告的结果是服务用户可接受性问卷(SUTAQ)，患者能力量表(PEI)和头晕障碍量表(DHI)。物理结果测量包括Mini-BESTest(MB)，修改后的动态步态指数(mDGI)，步态速度(GS),运动过程中的动态视力（DVA）和头部运动学和症状。
■16个PwMS（14个女性），平均年龄44(±14)岁被纳入研究,12人完成VPT.坚持锻炼，数字测量为60%(±18.4)。SUS得分很高，为81（±14），SUTAQ得分也显示出系统的高度满意度和可接受性。MB的统计学显着改善（平均变化2.25；p=0.004），mDGI（中位数变化1.00；p=0.008），发现DVA(中位数变化-1.00;p=0.004)。头部频率随着头部运动过程中头晕强度的降低而显着改善（4次凝视稳定练习的平均变化为每分钟23次；p<0.05）。在DHI(p=0.07)和GS(p=0.15)中观察到非显著的改善。64.5%的随访是远程(视频或电话)进行的，在系统的推动下。
■这项研究对PwMS有两个主要结果和益处。首先,我们表明所使用的系统既可以接受，也可以被PwMS使用。其次,我们证明了一系列头晕的改善，平衡和步态指标与远程提供的护理。该系统有可能对MS理疗服务提供产生积极影响，并有可能提供有效的远程护理。
■本研究调查了商用数字VPT系统（可穿戴式头部传感器，智能手机应用程序和临床医生软件)向PwMS提供VPT。采用治疗前/后设计，主要结果是系统可用性量表（SUS）。其他患者报告的结果是服务用户可接受性问卷(SUTAQ)，患者能力量表(PEI)和头晕障碍量表(DHI)。物理结果测量包括Mini-BESTest(MB)，修改后的动态步态指数(mDGI)，步态速度(GS),运动过程中的动态视力（DVA）和头部运动学和症状。
■16个PwMS（14个女性），平均年龄44(±14)岁被纳入研究,12人完成VPT.坚持锻炼，数字测量为60%(±18.4)。SUS得分很高，为81（±14），SUTAQ得分也显示出系统的高度满意度和可接受性。MB的统计学显着改善（平均变化2.25；p=0.004），mDGI（中位数变化1.00；p=0.008），发现DVA(中位数变化-1.00;p=0.004)。头部频率随着头部运动过程中头晕强度的降低而显着改善（4次凝视稳定练习的平均变化为每分钟23次；p<0.05）。在DHI(p=0.07)和GS(p=0.15)中观察到非显著的改善。64.5%的随访是远程(视频或电话)进行的，在系统的推动下。
■这项研究对PwMS有两个主要结果和益处。首先,我们表明所使用的系统既可以接受，也可以被PwMS使用。其次,我们证明了一系列头晕的改善，平衡和步态指标与远程提供的护理。该系统有可能对MS理疗服务提供产生积极影响，并有可能提供有效的远程护理。
