Effectiveness of telerehabilitation in managing chronic low back pain: a pragmatic randomized controlled non-inferiority trial.

Study Summary

50 aged 18 years or more with nonspecific chronic low back pain (CLBP) were included in this pragmatic non-inferiority controlled trial in which patients were randomized to either receive telerehabilitation (TR) or conventional in-person rehabilitation. Telerehabilitation consisted of individualized aerobic, stretching, and core-strengthening exercises combined with education and self-management support delivered through videoconferencing, telephone calls, and messaging, whereas conventional rehabilitation was individualized according to routine clinical practice and could include supervised exercise, hands-on techniques, and other therapeutic modalities. The primary outcome was pain intensity measured using the Numeric Rating Scale (NRS). Secondary outcomes included disability (ODI), quality of life (SF-12), pain catastrophizing (PCS), and Tampa Scale for kinesiophobia (TSK). Outcomes were assessed at baseline and after the six-week intervention. Overall, both groups experienced comparable clinical improvements, with no statistically significant between-group differences across measured outcomes. However, telerehabilitation did not demonstrate non-inferiority for the primary pain outcome, whereas non-inferiority was demonstrated for disability. These findings suggest that telerehabilitation may be a clinically useful alternative when functional improvement and accessibility are priorities, but in-person rehabilitation may remain preferable when pain reduction or hands-on treatment is particularly important.