Abstract
Studies on validation of telerehabilitation as an effective platform to help manage as well as reduce burden of care for Low-Back Pain (LBP) are sparse. This study compared the effects of Telerehabilitation-Based McKenzie Therapy (TBMT) and Clinic-Based McKenzie Therapy (CBMT) among patients with LBP. Forty-seven consenting patients with chronic LBP who demonstrated ‘directional preference’ for McKenzie Extension Protocol (MEP) completed this quasi experimental study. The participants were assigned into either the CBMT or TBMT group using block permuted randomization. Participants in the CBMT and TBMT groups received MEP involving a specific sequence of lumbosacral repeated movements in extension aimed to centralize, decrease, or abolish symptoms, thrice weekly for eight weeks. TBMT is a comparable version of CBMT performed in the home with the assistance of a mobile phone app. Outcomes were assessed at the 4th and 8th weeks of the study in terms of Pain Intensity (PI), Back Extensors Muscles’ Endurance (BEME), Activity Limitation (AL), Participation Restriction (PR), and General Health Status (GHS). Data were analyzed using descriptive and inferential statistics. Alpha level was set at p< 0.05. Within-group comparison across baseline, 4th and 8th weeks indicate that both CBMT and TBMT had significant effects on PI (p=0.001), BEME (p=0.001), AL (p=0.001), PR (p=0.001) and GHS (p=0.001) respectively. However, there were no significant differences (p>0.05) in the treatment effects between TBMT and CBMT, except for ‘vitality’ (p=0.011) scale in the GHS where TBMT led to significantly higher mean score. Mobile-app platform of the McKenzie extension protocol has comparable clinical outcomes with the traditional clinic-based McKenzie Therapy, and thus is an effective supplementary platform for care of patients with low-back pain.
Highlights
Chronic Low-Back Pain (LBP) is more resistant to therapeutic intervention than the other forms of back pain (Fersum 2010), as a result, treatment intervention in the affected patients give variable outcomes (Rainville, Sobel, Hartigan, & Wright, 1997)
The objective of this study was to compare the efficacy of Clinic-Based MT (CBMT) and Telerehabilitation-Based McKenzie Therapy (TBMT) on physiological and psychosocial variables in patients with chronic non-specific LowBack Pain (LBP)
This study compared the effect of Clinic-Based McKenzie Therapy (CBMT) and TBMT on pain intensity, back extensors muscles’ endurance, activity limitation, participation restriction, general health status, and cost-utility in patients with chronic non-specific LBP
Summary
Chronic Low-Back Pain (LBP) is more resistant to therapeutic intervention than the other forms of back pain (Fersum 2010), as a result, treatment intervention in the affected patients give variable outcomes (Rainville, Sobel, Hartigan, & Wright, 1997). Consequent to the foregoing, exercise has become the central element in the physical therapy management of patients with chronic non-specific LBP (Hayden, van Tulder, Malmivaara, & Koes, 2005; van Tulder et al, 2003). Telerehabilitation is considered as a potential solution to bridge service delivery gap, especially in geographically remote areas with shortage of health care personnel and lack of access to physical therapy rehabilitation services (Dansky, Palmer, Shea, & Bowles, 2001). There is an apparent dearth of studies on the telerehabilitation application of McKenzie therapy in patients with chronic non-specific LBP. The objective of this study was to compare the efficacy of Clinic-Based MT (CBMT) and Telerehabilitation-Based McKenzie Therapy (TBMT) on physiological (pain intensity and back muscles endurance) and psychosocial (activity limitation, participation restriction, and general health status) variables in patients with chronic non-specific LBP
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