THE EFFECTS of TELEREHABILITATION with REMOTELY SPINAL STABILIZATION EXERCISES on CLINICAL VARIABLES, FUNCTIONAL ACTIVITIES, EXERCISE ADHERENCE and MUSCLE ARCHITECTURE of NECK MUSCLES in INDIVIDUALS with CHRONIC NECK PAIN

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.