Comparison of the effects of internet-based and supervised exercise programs in people with multiple sclerosis

Multiple sclerosis is a disease characterized by autoimmune inflammatory demyelination. MS can cause decreased functional capacity, gait and balance disorders, fatigue. These symptoms observed are more frequent and severe as the level of disability increases in MS patients. Exercise programs are important in the treatment of MS. The aim of our study is to investigate the effects of supervised and internet-based exercise programs on functionality, walking, balance, fall efficiency, fatigue, daily living activities, quality of life and participation and their superiority to each other in severe MS patients. Thirty-four MS patients were included to the study and randomly divided into supervised exercise program group and internet based exercise program group. After taking the demographic and clinical information, functionality '2 Minute Walk Test', 'Timed Get Up Walk Test' and '5 Times Sit To Stand Test', walk 'Timed 25-Foot Walk' and 'Multiple Sclerosis Walking Scale-12', balance 'Berg Balance Scale', fall efficiency 'Modified Falls Efficiency Scale', fatigue 'Fatigue Severity Scale', activities in daily life 'Multiple Sclerosis Impact Scale-29', quality of life 'Multiple Sclerosis International Quality of Life Scale' and participation was assessed by the 'Canadian Occupational Performance Measure'. Participatiants in the supervised exercise program group were performed by a physiotherapist at home and patients in the internet-based exercise program group were given an exercise program consisting of aerobic, strengthening and balance exercises 2 days a week for 8 weeks via the website. Our study was completed with a total of 30 patient, 15 in Group I (13 women, 2 men) and 15 in Group II (11 women, 4 men). After treatment, a statistically significant difference was found in all parameters in the the supervised exercise program group and in all evaluation parameters except walking speed in the internet-based exercise program group (p<0.05). It was found that the supervised exercise program group was superior in functionality and balance evaluation parameters compared to the internet-based exercise program group (p<0.05). As a result, it was found that an exercise program consisting of aerobic, strengthening and balance exercises had positive effects on functionality, walking, balance, falling efficiency, fatigue, daily living activities, quality of life and participation severe MS patients. We believe that the significant superiority seen in the functionality and balance results in the supervised group is caused by implementation of an exercise program accompanied by a physiotherapist at the patients' homes.