Effects of Face-to-Face Versus Telerehabilitation-Based Circuit Training in People With Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease characterized by inflammation, demyelination, and axonal loss in the central nervous system, affecting functions such as balance, walking, muscle strength, and fatigue, thereby reducing individuals' participation in activities and quality of life. Balance, coordination, strengthening, and aerobic exercise approaches are widely used in MS rehabilitation, and these methods are supported by a high level of evidence for improving functional capacity. One method that allows these approaches to be combined and structured around functional tasks is circuit training, in which exercises are organized as consecutive stations with short rest intervals. Circuit training is defined as a comprehensive exercise model that targets endurance, balance, strength, and motor control components within the same session. Straudi et al. demonstrated that supervised and home-based task-oriented circuit training improved walking endurance and had positive effects on walking speed, functional mobility, fatigue, and muscle oxygen consumption. Doğan et al. reported that telerehabilitation- and virtual reality-supported circuit training improved trunk control, upper extremity function, and ataxia severity. In a meta-analysis conducted by Du et al., circuit training interventions were reported to have positive effects on balance, walking, fatigue, and quality of life in individuals with MS. However, studies directly investigating circuit training in individuals with MS are limited. In recent years, telerehabilitation has emerged as a contemporary approach that provides access independent of distance; however, the need for further controlled studies to strengthen the level of evidence in MS has been emphasized. The aim of this study is to investigate and compare the effects of an 8-week circuit training program delivered face-to-face and through synchronous telerehabilitation on walking capacity, functional mobility, lower-extremity muscle strength, fatigue, activities of daily living, and quality of life in individuals with MS.