ABSTRACT
BackgroundChronic low back pain is a very common problem worldwide. Reasons such as repetitive problems and lack of a clear treatment cause low back pain to be a serious burden for society [1]. Telerehabilitation provides remote application of rehabilitation services with the developing technology. Especially in the COVID-19 pandemic, the problems experienced in health services have increased the popularity of telerehabilitation services [2].ObjectivesAim in this study is to investigate the effects of spinal stabilization exercises performed remotely with asynchronous video clips on pain, disability, quality of life, trunk flexion range of motion and gait parameters.MethodsA total of 20 individuals with chronic low back pain were included in the study. After recording demographic information, pain levels were evaluated with the Visual Analogue Scale (VAS), disability levels were evaluated with the Oswestry Disability Index (ODI), and quality of life was evaluated with the Nottingham Health Profile (NHP). Trunk flexion range of motion was evaluated with the Valedo ® system (Hocoma, Switzerland), and the spatiotemporal parameters of the gait (step time, cadance) were evaluated with the OPTOGAIT system (OPTOGait, Microgate, Italy). After the evaluation, the individuals were divided into 2 groups. One group did face-to-face progressive spinal stabilization exercises in the clinic, while the other group did the same exercise program remotely with asynchronous videos. The exercise program was 8 weeks, 3 days a week.ResultsThe mean age of the telerehabilitation group (4 M, 5 F) was 41.44 ± 9.74, and their body mass index (BMI) was 26.34 ± 3.1. The mean age of the clinical group (1 M, 8 F) was 41.0 ± 13.0, and their BMI was 27.64 ± 3.55. All parameters were similar in the two groups before treatment. There was a significant difference in parameters except gait parameters in both groups after treatment (p<0.05). In the evaluation between the groups after treatment, the results of the two groups were similar in all parameters (p>0.05) (Table 1).Table 1.Baseline and after treatment characteristics of telerehabilitation and face to face group and comparison of with-in group and between groupTelerehabilitationFace to FaceBaselineAfter Treatmentp valueBaselineAfter Treatmentp valueBetween GroupVAS6.51±1.612.41±1.170.00*6.62±0.952.33±1.980.00*0.79ODI20.66±9.9413.55±100.00*30.22±15.517.11±120.02*0.54NHP131.51±121.2934.0±29.610.01*203.55±60.0763.08±76.240.00*0.66Trunk Flexion Range of Motion99.55±12.24106.55±7.510.04*88.11±15.2694.11±15.180.00*0.09Step length (cm)60.67±9.0764.35±9.580.5153.82±2165.95±9.410.170.54Step Time (sec)0.55±0.040.51±0.080.260.40±0.120.34±0.180.130.06Cadance105.67±9.17106.13±17.460.44103.37±8.64105.31±9.450.670.73ConclusionAccording to the results of our study, it is seen that both methods did not provide any change in gait parameters. However, it has similar effects in reducing pain and disability, improving quality of life, and increasing trunk range of motion. For individuals with chronic low back pain, it seems that remote exercise with asynchronous videos can be as effective a treatment as face-to-face exercise. There is a need for studies to be conducted in a larger population with longer follow-up.References[1] Anderson GB. epidemiological features of chronicles low back pain _ the lance _ 1999;354(9178):581-5.[2] Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal physical therapy during the COVID-19 pandemic: is telerehabilitation the answer? Phys. ther. 2020;100(8): 1260-4.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
ABSTRACT
Background: In recent years, it has been emphasized that preventive rehabilitation approaches for problems such as low back and neck pain, which are very high in health expenditures, are more cost-effective than treating them. Due to the Covid-19 pandemic, risk factors for individuals' spinal health have increased and access to health care has become difficult (1). Therefore, interest in tele-rehabilitation, which is an important part of telehealth, has increased recently. Objectives: This study aims to investigate the effectiveness of remote and face-to-face spinal stabilization exercise training on functional capacity tests in asymptomatic individuals. Methods: Individuals who did not have chronic low back and neck pain and between the ages of 18-55 were included in the study. While the face-to-face group traditionally exercised under the supervision of a physiotherapist, the tel-erehabilitation group exercised with videoconferencing and asynchronous video recordings. Both groups performed progressive spinal stabilization exercises 3 days a week for 8 weeks (2). Before and after the training functional capacity tests (repetitive reaching, lifting object overhead, and sustained overhead work) were performed (3). Results: Twenty (11 female, 9 male) individuals with a mean age of 30,252±9.06 and a mean body mass index of 24.36±4.09 were included in the study. There was no difference between the baseline values of functional capacity test scores of both groups (p>0.05). There were signifcant improvements in the repetitive reaching and sustained overhead work tests after the exercise program in both groups (p< 0.05), while there was no difference in the lifting object overhead test (p> 0.05). There was no difference between the changes in functional capacity test scores between the groups after the training (p> 0.05). Conclusion: According to our preliminary results, face-to-face and remote spinal stabilization exercise programs caused similarly positive changes in functional capacity test scores (repetitive reaching, sustained overhead tests) of asymptomatic individuals. These exercises are known to improve deep muscle activation. This development may have led to improvements in tests, which mostly evaluate speed, coordination and endurance. Weight lifting capacities have not changed. This may be because stabilization exercises focus more on deep muscle activation and not on developing superfcial muscle strength like upper extremity strength(2). Success of exercise training with telerehabilitation may have contributed to the younger population and possibly better adaptation to technology. It is planned that these preliminary results will be extended and make greater contributions to the current literature.
ABSTRACT
Background: Low back and neck pain is one of the most common health problems in society and one of the top reasons for admission to the hospital (1). Studies show that the level of physical activity decreases in individuals with chronic pain, and the cognitive level and quality of life are negatively affected (2). There are studies examining the effects of the Covid-19 pandemic process on the level of physical activity and cognitive level in various groups. However, the number of studies on how the history of Covid-19 affects individuals with low back and neck pain is limited. Objectives: The aim of this study is to examine the effect of Covid-19 history on cognitive level, pain catastrophe and physical activity level in individuals with chronic low back and neck pain in individuals. Methods: A total of 25 individuals with chronic pain, including 16 with low back pain and 9 with neck pain, were included in the study. Demographic data such as age, gender and body mass index (BMI) were obtained from all individuals. The education levels of the individuals were recorded. Cognitive level was assessed by the Montreal Cognitive Assessment (MoCA)[3], pain severity was assessed by the Visual Analog Scale (VAS), pain catastrophization was assessed by the Pain Catastrophizing Scale (PCS)[4], and physical activity level was assessed by the International Physical Activity Questionnaire-Short Form (IPAQ-SF)[5]. Results: Table 1. Demographic data, VAS, MoCA, PCS, and IPAQ-SF scores are given in Table 1. 7 of the participants had history of Covid-19, 18 did not. The MoCA scores and education levels of individuals with Covid-19 were higher than individuals without history of Covid-19 (p<0.05). There was no difference in physical activity, pain and pain catastrophization levels between the 2 groups (p> 0.05). Conclusion: Surprisingly, individuals who had a history of Covid-19 had higher cognitive levels than individuals without a history of Covid-19. In addition, there was no difference between physical activity and pain catastrophization levels. This may be due to the higher education level of individuals with a history of Covid-19. There is a need for further studies in which education levels are similar, and hospitalization and the Covid-19 positivity process are examined in more detail.
ABSTRACT
Background: Doing a job with functional activity may aggravate chronic neck pain(CNP). Thickness, PCSA of the neck muscles can be improved with exercise. During the Covid-19 pandemic, people has caused an increase in home workload, the frequency of performing functional activities related to performance has increased. The distance between physiotherapists and the patient should be at least 2 meters in clinics due to the risk of transmission. As a result, the importance of telerehabilitation has increased. Objectives: Our aim is to investigate the effect of remotely spinal stabilization exercises(SSE) with telerehabilitation on clinical variables, the functional activities, exercise adherence and muscle architecture patients with CNP. Methods: The demographic characteristics were recorded. Pain intensity with Visual Analog Scale (VAS), disability level with Neck Disability Index (NDI), neck awareness with Fremantle Neck Awareness Questionnaire (FreNAQ), the functional capacity levels with neck function capacity evaluation test, the difficulty of functional activities with VAS were assessed. Muscle thickness of M. Sterno-cleideomastoideus, M. Upper Trapezius, PCSA of M. Longus Colli, M. Cervical Multifdus was evaluated in the resting with 3.5-10 MHz ultrasound. The exercise adherence with Exercise Adherence Rating Scale and exercise program satisfaction with VAS were evaluated. The telerehabilitation group (TG) used exercises videos and video conferences, control group (CG) did SSE in the clinic. To study the effects of the interventions, the outcome measures were compared time-by-group interaction effects, one the within-groups factor (time) and one the between-groups factor (group) by repeated-measures two-way ANOVA. The Mann Whitney-U test was performed to compare two groups for non-parametric data. Results: Twenty-eight patients were randomly allocated to the TG and the CG. The VAS, NDI, FreNAQ, the functional capacity levels, muscle architecture showed similar changes over time in both groups. Results showed no signifcant time-by-group interaction effects of VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p>0.05);a signifcant effect for time in the VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p<0.001). There was no difference between the groups in terms of VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture. Results showed no signifcant effect for the group in the VAS, NDI, FreNAQ, the functional capacity levels, the difficulty of functional activities and muscle architecture (p>0.05). Both groups adapted well to the exercise program and were highly satisfed with the SSE (p<0.05). Conclusion: The VAS, NDI, difficulty of functional activities decreased;FreNAQ, functional capacity levels, architecture of neck muscles increased in both groups after 8 weeks SSE. It was determined that telerehabilitation with remotely SSE was benefcial as face-to-face SSE.