MS Home Physiotherapy by Video: A Guide

Fatigue and day-to-day changes

A 2024 meta-analysis of 13 randomized trials reported improvements with tele-exercise in fatigue (SMD −0.58), quality of life (SMD 0.38), physical health (SMD 0.62), depression (SMD −0.51) and mental health (SMD −0.48). The abstract did not give the total number of participants, and the authors called for more research on long-term effects and program design. These are pooled study results—not a promise about what one person will experience.

A broader 2024 review covered 54 studies of home-based digital exercise, involving 2,359 people with MS. Results for fatigue were inconsistent, and the review noted varied, sometimes incomplete reporting of program details and adherence. It also reported 15.4% dropout across the studies; that is not an individual risk estimate or a measure of safety.

If symptoms fluctuate, a video visit can be a chance to describe what has changed and discuss how movement feels on that particular day. A brief note of fatigue, walking or balance changes, and how daily activities are going may help you explain your experience; it is not a prescribed monitoring plan.

Mobility and balance

A 2024 review of physical telerehabilitation for gait and balance found eight studies with 355 participants. The authors saw a possible benefit, especially in exergaming studies, but said larger, more robust trials were needed.

One multicentre home-based virtual-reality trial, published in a 2022 journal issue, included 70 participants. After six weeks, the study reported greater improvement in some balance and walking measures for the VR group than for the home conventional-treatment group. Adherence was 86.67% and 80%, respectively. This was a specific VR program—not proof that ordinary video physiotherapy is equivalent to in-person sessions.

What video can—and cannot—assess

A video appointment lets you talk through your experience and can show visible movement within the camera view. It cannot provide hands-on assessment or show everything about how you move and manage daily life. If the picture is unclear, you feel unsafe moving, or the question needs an in-person assessment, say so.

A 2026 U.S. Deep South study compared remote video-supervised exercise with an in-person program in 456 adults. It was a quasi-experimental preprint, not peer-reviewed evidence. Remote exercise did not meet the study’s non-inferiority criteria for self-reported fatigue, pain and physical health. Some measured performance outcomes were described as comparable. This mixed result is a reason not to promise equivalence.

Home, caregiver and access

A home appointment may reduce travel, but access to a suitable device, connection, privacy and a comfortable space can matter. A caregiver may be included if you want their help; their presence should not be assumed. Tell the physiotherapist if technology, language, fatigue or the home setup makes a session difficult.

When to seek in-person or urgent help

A video call is not a substitute for urgent care. If symptoms are sudden or severe, or you have been injured, seek local urgent medical help rather than waiting for a routine teleconsultation. Ask for an in-person assessment when you need the therapist to evaluate movement or safety beyond what can be seen on video.