Physical, cognitive and psychosocial effects of telerehabilitation-based motor imagery training in people with multiple sclerosis: A randomized controlled pilot trial

Introduction Motor imagery training delivered at home via telerehabilitation is a novel rehabilitation concept. The aim was to investigate the effects of telerehabilitation-based motor imaging training (Tele-MIT) on gait, balance and cognitive and psychosocial outcomes in people with multiple sclerosis (pwMS). Methods This randomized, controlled pilot trial included pwMS and healthy individuals. pwMS were randomly divided into two groups, intervention and control. The intervention group received Tele-MIT twice a week for 8 weeks. The control group was a wait-list group without any additional specific treatment. Healthy participants served as a baseline comparison. The Dynamic Gait Index, used to assess dynamic balance during walking, was the primary outcome. Secondary outcomes included assessments of walking speed, endurance and perceived ability, balance performance assessed by a computerized posturography device, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life. Results Baseline comparisons with healthy individuals revealed that motor imagery abilities were preserved in pwMS (p > 0.05). The intervention group exhibited significant improvements in dynamic balance during walking (p = 0.002), walking speed (p = 0.007), perceived walking ability (p = 0.008), balance confidence (p = 0.002), most cognitive functions (p = 0.001-0.008), fatigue (p = 0.001), anxiety (p = 0.001), depression (p = 0.005) and quality of life (p = 0.002). No significant changes were observed in the control group in any of the outcome measures (p > 0.05). Discussion Tele-MIT is a novel method that proved feasible and effective in improving dynamic balance during walking, walking speed and perceived walking ability, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life in pwMS.