The goal of this feasibility study is to test the safety and effectiveness of an high-intensity task oriented circuit training program, followed by three months of telerehabilitation in people with mild to moderate Multiple Sclerosis (MS). The main questions it aims to answer are:
* Can high-intensity task oriented circuit training improve gait and balance functional capacity? * Can telerehabilitation mantain the benefits in gait and balance gained via circuit training for a six month period?
Participants will:
* Complete 10 session ( one hour each, three times a week) of high-intensity task oriented circuit training administered in a hospital setting. The training will target key motor skills such as walking, stepping, supine to stand transitions and general mobility. * Engage in 3 months of asynchronous telerehabilitation (without physiotherapist supervision)
Diagnosis of primary or secondary progressive multiple sclerosis according to the McDonald criteria.
Mini-Mental State Examination (MMSE) score > 24.
Expanded Disability Status Scale (EDSS) score ≤ 6.
Presence of other psychiatric or neurological disorders.
Cardiopulmonary, renal, or liver diseases.
Pregnancy.
Modifications in drug treatment within the last 3 months.
Single group
High Intensity Task Oriented Circuit Training + Telerehabilitation
BehavioralParticipants will receive 10 sessions of high-intensity, task-oriented circuit training, three times a week. Each session will last 60 minutes, with minutes of active training. Each session will include three rounds, each lasting 55 minutes. During each round, participants will rotate between stations working for four minutes at each station, followed by three minutes of rest. The stations will focus on key motor skills, including supine to stand transitions, walking speed and functional capacity, walking adaptability and stepping. After in-hospital treatment participants will receive 36 sessions of asynchronous telerehabilitation, three times a week for 12 weeks. This intervention will be supported by low-cost, off-the-shelf technology for treatment delivery and monitoring.
Change in Balance
The change in balance will be assessed using the Fullerton Advanced Balance Scale
Change in mobility, balance, walking ability, and fall risk
Mobility, balance, walking ability, and fall risk will be assessed through Timed Up and Go Test
Change in Dual task Cost
Dual Task Cost will be assessed by the difference between Timed Up and Go and Dual Task Timed Up and Go
Change in quantitative mobility and leg function performance
Leg function performance and quantitative mobility assessed through Timed 25 Foot Walk
Change in auditory information processing speed and flexibility
Paced Auditory Serial Addition Test will be used to assess auditory information processing speed and flexibility
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