Effectiveness of the Neck-Specific Exercise Program Through TeleRehabilitation Compared to the Usual Intervention in Functional Recovery in Adults With Acute Cervical Sprain Grade I and II in the First Level of Care

The neck-related musculoskeletal disorders (MSDs), whether attributed to work, injury, or other activities manifest neck pain, are a prevalent source of disability and a common reason for consulting primary health care providers, including physical therapists and primary care physicians. Neck pain related to disorders associated with cervical sprain is the most common result of car accidents. Associated cervical sprain disorders disrupt the daily lives of adults worldwide and are associated with considerable pain, suffering, disability and costs. Cervical sprain (CD), also known as whiplash-associated disorder, is the result of a combined extension/flexion injury of the soft tissues of the cervical spine due to an acceleration-deceleration mechanism of energy transfer to the neck. The Quebec Task Force Classification System, is the classification that determine the degree of injury. This classification is based solely on clinical signs, dividing them into 5 categories: 0. Asymptomatic, 1. Cervical pain, muscle spasm, no physical signs, 2. Stiffness, localized pain, 3. Symptoms, signs and neurological clinic and 4. Bone injury, fracture/dislocation.

The objective of treatment should be aimed at restoring the functionality of the individual with a biopsychosocial approach, so that structured patient education should be considered, making patients aware of the typical course and treatment of grade I-II CD, the importance of maintaining life activities and movement, to actively participate in your care plan by remaining active and maintaining neck movement, emphasizing active treatments instead of passive treatments. The main objective is to reincorporate the patient into daily life activities. Functionality is defined as: "the ability of the person to autonomously perform the activities of daily living." The loss of functionality in CD is associated with chronic pain, limitation in the arcs of movement, it is also an indicator of mental health. The effects of telerehabilitation, when associated with usual care or as an independent intervention, have also been evaluated in chronic non-malignant musculoskeletal pain. The use of telerehabilitation as a tool for conducting MSD assessments has been investigated, specifically in adults with non-specific neck pain compared to conventional methods, finding validity and reliability, thus adding more evidence to the existing evaluation based on telerehabilitation for MSDs.

Problem statement: In Mexico, the Mexican Institute of Social Security provides care for this type of condition, however in the Family Medicine Units (primary health) there are no physiotherapists who evaluate and manage the cervical sprain early which has been demonstrated, has an impact on the functional recovery time of patients with muscle injuries, the above is important since it has been shown that early rehabilitation is one of the most effective strategies for functional recovery in musculoskeletal disorders.

Research question: What is the effectiveness of the Neck-Specific Exercise Program by telerehabilitation compared to the usual intervention in functional recovery in adults with grade I and II acute cervical sprain at the first level of care?

Hypothesis: The effectiveness of the Neck-Specific Exercise Program in functional recovery in adults with grade I and II acute cervical sprain who performed the neck-specific exercise program using telerehabilitation for 6 weeks is that they will improve at least 3.5 points or more in levels of functionality through the Neck Disability Index (NDI) compared to those who performed the usual intervention.