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 (eta2p 0.01 to 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.

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