Association Between System Usage Pattern and Impact of Web-Based Telerehabilitation in Patients with Multiple Sclerosis

Patients with multiple sclerosis (PwMS) increasingly use online services for managing their healthcare. The objective of this study was to investigate web log data (weblogs) generated by PwMS in the process of web-based telerehabilitation and correlate them with rehabilitation progress. The weblogs from 17 patients (female: 15, male 2; mean age: 60.1 +/- 11.4 years) were tracked for an average period of 153.6 +/- 38.3 days with the total number of log events and page visit records of 1,457 and 37,030, respectively. The time and frequency of patients' web visits were investigated as well as their adherence to prescribed exercise regimen. Rehabilitation progress was gauged by changes in quality of life, mobility, and sleep ascertained by measuring MSQOL, 2MWT and PSQI respectively. The changes in these metrics were correlated with system usage patterns. On average, PwMS visited 30 pages a day for 26.5 minutes, with a single login amounting for 27 pages in duration of 22.0 minutes. The average exercise program comprised 6.9 sets and 29.1 repetitions with average set and repetition completion rates of 46.5% and 72.6% respectively. A statistically significant association has been found between time spent in the online exercise mode and clinical improvements. The results of the study demonstrate that the patients had more pronounced outcome improvements when they increased the time of using the telerehabilitation system for home-based exercise. The results of this study could contribute to the development of more efficient home-based telerehabilitation systems.