Effects of a Hybrid Telerehabilitation Model on Mobility and Functional Capacity in patients with Multiple Sclerosis: A Single Blind Randomized Controlled Study.

Abstract

To investigate the effects of hybrid telerehabilitation (Hybrid TR), telerehabilitation (TR-only), and clinic-based rehabilitation on gait speed (primary outcome: Timed 25-Foot Walk Test), as well as on fatigue, functional capacity, mobility, quality of life, and muscle activation in MS patients. A single blind randomized controlled trial with assessments conducted at baseline, mid-treatment (week 4), and post-treatment (week 8). Rehabilitation settings included hybrid (combination of telerehabilitation and clinic-based interventions), only telerehabilitation, and clinic-based environments. A total of 44 participants diagnosed with MS (Expanded Disability Status Scale scores ranging from 0 to 4) were randomized into three groups: Hybrid TR(Group A), TR-only(Group B), and clinic-based rehabilitation(Group C). Participants underwent an 8-week intervention program. Selection was based on specific eligibility criteria, and random allocation methods were applied. Participants engaged in an 8-week program consisting of breathing exercises, aerobic training, and strengthening exercises delivered through Hybrid TR, TR-only, or clinic-based rehabilitation. Primary outcome was mobility assessed by the Timed 25-Foot Walk(T25FW).Secondary outcomes included functional capacity assessed by 2-Minute Walk Test(2MWT), and mobility assessed by Timed Up and Go(TUG); fatigue assessed by the Modified Fatigue Impact Scale(MFIS); quality of life assessed by the Multiple Sclerosis International Quality of Life questionnaire(MusiQoL); and muscle activation measured by surface electromyography(EMG) of the rectus femoris muscle. Significant within-group improvements in mobility, fatigue, functional capacity, quality of life, and EMG parameters were observed by week 8 across all groups. However, statistically significant between-group differences were not observed, and effect sizes were small to moderate(η²ₚ = 0.01-0.07). Hybrid telerehabilitation appears to be a feasible and potentially beneficial approach for individuals with multiple sclerosis, with clinical outcomes that may be comparable to those of clinic-based rehabilitation in terms of mobility, fatigue, functional capacity, quality of life, and muscle activation.