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

OBJECTIVE

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 patients with multiple sclerosis (MS).

DESIGN

A single-blind randomized controlled trial with assessments conducted at baseline, mid-treatment (wk 4), and post-treatment (wk 8).

SETTING

Rehabilitation settings included hybrid (combination of telerehabilitation, clinic-based interventions), only telerehabilitation, and clinic-based environments.

PARTICIPANTS

A total of 44 participants (N=44) diagnosed with MS (Expanded Disability Status Scale scores ranging from 0 to 4) were randomly assigned into 3 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.

INTERVENTIONS: 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.

MAIN OUTCOME MEASURES: Primary outcome was mobility assessed by the Timed 25-Foot Walk. Secondary outcomes included functional capacity assessed by 2-Minute Walk Test, and mobility assessed by timed Up and Go; fatigue assessed by the Modified Fatigue Impact Scale; quality of life assessed by the Multiple Sclerosis International Quality of Life questionnaire; and muscle activation measured by surface electromyography of the rectus femoris muscle.

RESULTS

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).

CONCLUSIONS

Hybrid TR appears to be a feasible and potentially beneficial approach for individuals with MS, with clinical outcomes that may be comparable with those of clinic-based rehabilitation in terms of mobility, fatigue, functional capacity, quality of life, and muscle activation.