Researchers from the University of Glasgow are developing a simple and easy to use website to enable and encourage people who have Multiple-Sclerosis (MS) to exercise at home.

The most stripped back description of the website is that it provides videos demonstrating various tailored exercises for people with MS to improve their general health and fitness but also providing valuable physiotherapy that may prevent further deterioration in their health. The website is being perfected with invaluable help from people who have MS as well as others and in an interview with the MS Society Dr Lorna Paul of the University of Glasgow explains how their views have played a critical part in shaping the website. “There was to be no lycra involved”, she mentions smiling slightly, “they were quite specific about the lycra”.

It’s a funny little detail that is indicative of the generally sober tone that people have favoured throughout the trials so far. “The people with MS were specific” Dr Paul continues, “the actors in the videos should look like normal people wearing normal clothes in a normal environment. So it wasn’t to look like a clinical environment or a sports centre.”

Origins

The website came about when Dr Paul and the team from Glasgow University were looking at ways of bringing physiotherapy into the home and realised that accessibility was going to be a big issue. Initially physios were travelling long distances for relatively small clinical benefits. Then they looked at setting up community based classes in town centres but again, many people couldn’t access those. Speaking to bespoken Dr Paul explained - “What we then identified was we need another way, an alternative to patients, not a replacement of face to face, absolutely not. If people need face to face that’s alright, but for people who couldn’t access either face to face physio or go to an exercise class or do something how were we going to get physio and exercise to that group?”

A chance conversation sparked the idea of going digital to reach a wider group of people. They went onto work with the patient advisory group and coproduction groups with whose help they developed the website to reflect what the patients wanted to see rather than what the designers expected them to like. They also liaised with the MS Society and the Scottish Disability Forum to make sure the website was as accessible as was possible.

Removing the human element?

One criticism which has been levelled at the website is that it tends to eliminate the all important aspect of human contact and interaction in a group setting. But the point of the web based physio, Dr Paul explains to us, is to plug a gap in the provision of services rather than scrap human interaction.

“A lot of people when we spoke to them and interviewed them said they’re not that kind of person. They’re too embarrassed to be in a group [...] So they weren’t ever going to go to a group environment or they couldn’t get to that because they didn’t have transport, they were carers either for older people, or children or grandchildren”. Regarding Web Based Physio she continues, “this isn’t for everybody. This is for people who can’t access services to have some kind of provision in their own homes at a time that’s convenient”.

How does it work?

The first thing to know about Web Based Physio is that an individual cannot simply sign up.

“What happens is the person sees their physio. It’s for long term conditions so most people have access hopefully to a physio. The physio and their patient will agree what they think the problems are and what they want to address. For some people it might be balance, for some people it might be pain, for some people it might be fitness… and then on the back of the website we’ve got 150-200 exercises that the physio can then select for whatever problems the patient’s got.

Designed, among other things, for easy use, the physio can easily select and later deselect exercises for the patient to do. When the patient logs on they will see their personalised exercise programme. They can simply complete their exercises for the day but they can also leave messages for the physio to see if for instance they are having trouble with a particular exercise or find it too easy, etc.

Why physical fitness?

Looking specifically MS, there is a lot of evidence that shows that physical exercise has strong benefits to the person’s fitness and wellbeing, including things like balance, muscle strength, or keeping people’s joints moving, etc. But it also can have a positive effect in a more general way.

We know now that people with long term conditions need to exercise for the same reason as everybody else […] The advantage can be impairment specific but it is also just for general health and wellbeing […] we try and have a programme that addresses both of those things.

The Web Based Physio is now 9 months into a 2 year trial. If you would like to know how you can get involved or participate you can contact Dr Lorna Paul at Lorna.Paul@glasgow.ac.uk.

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