This single-center, assessor-blinded randomized controlled trial will recruit participants receiving routine follow-up at the Multiple Sclerosis Unit of the Department of Neurology, Van Yuzuncu Yil University Faculty of Medicine Hospital.
An independent researcher who is not involved in treatment or outcome assessment will generate the allocation sequence using computer-generated block randomization with a block size of eight. Participants will be assigned to synchronous or asynchronous telerehabilitation. The independent researcher will communicate each participant's allocation to the treating physiotherapist.
The synchronous program will be delivered through live videoconferencing by a physiotherapist certified in Pilates. The asynchronous program will use prerecorded exercise videos matched to the synchronous program in exercise intensity, with progression every two weeks. Participants in the asynchronous group will receive an exercise tracking form to record their participation.
Demographic and clinical information will be collected from participants and medical records. Physical performance assessments will be conducted by a physiotherapist blinded to treatment allocation, and neurological disability will be assessed by a neurologist. Outcome assessments will be performed at baseline and after the eight-week intervention to compare changes within and between groups.
