Effects of Clinical Based Versus Synchronized Telerehabilitation on Pain, Exercise Adherence, and Functional Disability Among Patients With Grade-II Cervical Spondylosis.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 52
- 试验地点
- 1
- 主要终点
- Pain Intensity
研究概览
简要总结
This randomized controlled trial aims to compare the effects of clinical-based rehabilitation and synchronized telerehabilitation on pain, exercise adherence, and functional disability in patients with Grade-II cervical spondylosis. A total of 52 participants will be randomly allocated into two parallel groups. Both groups will receive a standardized 6-week rehabilitation program, including cervical mobility exercises, strengthening, isometric exercises, stretching, and Mulligan self-mobilization techniques. The clinical group will receive in-person physiotherapy, while the telerehabilitation group will undergo real-time supervised sessions via video conferencing. Outcome measures will include pain (Numeric Pain Rating Scale), functional disability (Neck Disability Index), and exercise adherence (Exercise Adherence Rating Scale), assessed at baseline and post-intervention. The study aims to determine whether synchronized telerehabilitation is as effective as clinical-based rehabilitation and may provide a more accessible alternative for delivering physiotherapy care.
详细描述
Cervical spondylosis is a common degenerative condition of the cervical spine characterized by disc degeneration, osteophyte formation, and reduced cervical mobility, leading to neck pain and functional limitations. Grade-II cervical spondylosis represents a stage where patients are symptomatic but remain suitable for conservative management. Physiotherapy, particularly exercise-based rehabilitation, is widely used to improve pain, mobility, and functional capacity through strengthening, stretching, and neuromuscular re-education.
Clinical-based rehabilitation provides in-person physiotherapy with direct supervision, manual guidance, and real-time correction of exercises. However, access to such care is often limited due to barriers such as travel distance, cost, and time constraints. Synchronized telerehabilitation, delivered through real-time video conferencing, offers a potential alternative by enabling remote supervision, feedback, and patient engagement while maintaining continuity of care.
This randomized controlled trial aims to compare the effectiveness of clinical-based rehabilitation and synchronized telerehabilitation in patients with Grade-II cervical spondylosis. A total of 52 participants will be randomly assigned to two parallel groups. Both groups will receive a standardized 6-week rehabilitation program consisting of cervical range-of-motion exercises, deep cervical muscle strengthening, isometric exercises, stretching of the upper trapezius and levator scapulae, and Mulligan self-mobilization techniques (SNAGs). The clinical group will attend in-person sessions, while the telerehabilitation group will receive real-time supervised sessions via video conferencing.
Outcome measures include pain intensity assessed by the Numeric Pain Rating Scale (NPRS), functional disability measured by the Neck Disability Index (NDI), and exercise adherence evaluated using the Exercise Adherence Rating Scale (EARS), assessed at baseline and post-intervention.This study aims to determine whether synchronized telerehabilitation is comparable to clinical-based rehabilitation and may provide an accessible, cost-effective alternative for delivering physiotherapy care
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Blinding of participants and therapists is not possible due to the nature of interventions, as participants will know whether they are receiving clinical-based rehabilitation or synchronized telerehabilitation. However, a single-blind design will be used in which the outcome assessor remains blinded to group allocation. The assessor will not be involved in treatment delivery and will be instructed not to inquire about or be informed of participant group assignment. Outcome measures including NPRS, NDI, and EARS will be collected by the blinded assessor at baseline and post-intervention. Data analysis will also be performed using coded groups to reduce assessment and analytical bias.
入排标准
- 年龄范围
- 45 Years 至 64 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Middle age adults (45-64) years
- •Both gender ( male and female )
- •Clinical daignosis of cervical spondylosis grade 2
- •Mild to moderate pain on NPRS
- •Sub acute stage ( 2-6 weeks) of grade 2 cervical spondylosis
- •Able to follow instructions and give informed consent (cognitively able) Neurologically stable
排除标准
- •Prior cervical spine surgery within the last 1 months or cervical instability.
- •Inflammtory or systemic rheumatologic disease affecting the cervical spine (e.g., active rheumatoid arthritis ) or infection, tumor, fracture.
- •Severe cardiopulmonary or other medical comorbidity that contraindicates exercise (unstable angina, uncontriolled hypertension, recent MI)
- •Severe hearing or visual impairment
- •No smoking and daibetic history
结局指标
主要结局
Pain Intensity
时间窗: Measured at baseline (pre-intervention) and after 6 weeks (post-intervention completion).
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their average neck pain over the past 24 hours. The NPRS is a valid and reliable tool widely used in musculoskeletal conditions, including cervical spondylosis, to measure changes in pain severity.
Functional Disability
时间窗: Measured at baseline (pre-intervention) and at 6 weeks post-intervention completion.
Functional disability will be assessed using the Neck Disability Index (NDI), a validated questionnaire designed to measure the impact of neck pain on daily activities. It includes domains such as pain intensity, personal care, lifting, reading, work, concentration, sleep, and recreation. Each item is scored, with higher total scores indicating greater disability. The NDI is widely used in cervical spine disorders due to its strong reliability, validity, and sensitivity to clinical change.
Exercise Adherence
时间窗: Measured at baseline and at 6 weeks post-intervention completion.
Exercise adherence will be assessed using the Exercise Adherence Rating Scale (EARS), a validated self-reported questionnaire designed to measure the extent to which patients comply with prescribed home exercise programs. It evaluates behaviors such as frequency of exercise performance, consistency in following instructions, and patient commitment to rehabilitation. The scale provides insight into adherence patterns that directly influence treatment effectiveness in musculoskeletal conditions. Higher scores indicate better adherence to the prescribed exercise regimen. The EARS is widely used in rehabilitation research due to its good reliability and internal consistency.
次要结局
未报告次要终点
研究者
Dr. Khizra Hamid
Senior Lecturer
Lahore University of Biological and Applied Sciences