Effects of a Hybrid Telerehabilitation Model on Mobility and Functional Capacity in Patients With Multiple Sclerosis: A Single-Blind Randomized Controlled Study
Archives of Physical Medicine and Rehabilitation, cilt.107, sa.1, ss.11-20, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 107 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.apmr.2025.09.034
- Dergi Adı: Archives of Physical Medicine and Rehabilitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, MLA - Modern Language Association Database, SportDiscus, MLA International Bibliography
- Sayfa Sayıları: ss.11-20
- Anahtar Kelimeler: Fatigue, Hybrid telerehabilitation, Mobility, Multiple sclerosis, Physical therapy, Quality of life, Rehabilitation, Randomized controlled trial, Telerehabilitation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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.