Effects of Telehealth-Supervised Respiratory Exercise Training on Respiratory Function, Fatigue, Quality of Life, and Functional Capacity of Patients with Multiple Sclerosis

Abstract

Background and Objectives: Telerehabilitation (TR) offers an innovative approach to overcome accessibility challenges in managing multiple sclerosis (MS). This exploratory study evaluated the efficacy of integrating respiratory exercises into TR programs for improving respiratory function, fatigue, and quality of life. Materials and Methods: A randomized controlled trial involving 48 MS patients randomized into TR and control groups was conducted. Both groups performed respiratory exercises over eight weeks. Pulmonary function, fatigue severity (FSS), quality of life (MSQOL-54), and functional capacity (6MWT) were assessed before and after the intervention. Results: Both groups demonstrated significant within-group improvements in FEV1 (L), PEF (L), FEF%25-75 (L), FSS, MSQOL-54 physical and mental subscales, and the 6MWT distance (p < 0.05). The TR group exhibited unique improvements in FEV1 (%) and slightly greater reductions in fatigue, although the intergroup differences were not statistically significant. Conclusions: Telerehabilitation incorporating respiratory exercises effectively enhances the respiratory function, fatigue, and quality of life of MS patients, suggesting a viable alternative to conventional rehabilitation. Future studies should focus on advanced-stage MS, long-term sustainability, and technological integration to optimize the potential of TR.

Keywords: fatigue; multiple sclerosis; quality of life; respiratory function tests; telerehabilitation.

Figure 1

Flowchart of patient selection and group allocation. The figure illustrates the process of patient selection, exclusion, and final allocation into the study groups.

Figure 2

Overview of the study design. The study design includes two groups (control and telerehabilitation, n = 24 each), with both undergoing breathing exercises (pursed-lip, diaphragmatic, and segmental). Parameters assessed: pulmonary function tests (PFTs), 6 min walk test (6MWT), Multiple Sclerosis Quality of Life-54 (MSQL-54), and Fatigue Severity Scale (FSS). The telerehabilitation group performed exercises remotely under a physiotherapist’s supervision. Duration: 8 weeks, 2 sessions/week.