Telerehabilitation-based Exercises vs Standard Home-based Exercise in Low Back Pain

The objective of the study is to compare the effect of a telerehabilitation-based exercise program, versus a home therapeutic exercise program scheduled through a dossier and an exercise diary, with respect to disability (measured using the OSWESTRY questionnaire) and other variables (range of motion, strength, fatigue, histological changes, pain, medication intake, psychosocial factors and adherence), in patients with low back pain.

This randomized controlled trial has a parallel design, with two groups. Both groups will complete an 8-week home exercise program that includes flexibility and strength exercises. The program will be carried out with a frequency of 3 weekly sessions, preferably on alternate days. In the case of the experimental group, the program will be carried out with the support of the TRAK computer tool (https://www.trakphysio.com/es/), which allows the exercises to be carried out in front of a camera that, with the help of an artificial intelligence system, offers feedback to the participant and allows investigators/clinicians to keep a record of the sessions. In the case of the control group, the program will be carried out with the support of an information dossier of the exercises to be performed and a monitoring diary in which everything related to the sessions carried out will be noted. In both groups, as an addition to the home sessions, two face-to-face sessions will be held in the first and fifth weeks, respectively.

The exercise program includes flexibility and strength exercises, each made up of three levels of difficulty (easy, intermediate and difficult), with patients advancing to subsequent levels once each level is successfully overcome.

Inclusion criteria

• Nonspecific subacute or chronic low back pain

Exclusion criteria

• Neuropathic pain
• Pain below the knees
• Pain in legs with tingling, sensation of current or sensory alterations
• Positive neurological tests. Lack of strength, sensitivity or altered reflexes
• Canal stenosis
• Nociplastic pain (fibromyalgia, generalized pain, emotional lability, affective and cognitive implications)
• Previous lumbar surgery
• Specific pathology (rheumatic, spondylolisthesis, oncological, fractures...)
• Pregnancy
• Performing medium-high intensity exercise of more than 100 minutes a week
• Pathology that prevents exercise (decompensated cardiac pathology, decompensated respiratory pathology, significant mobility difficulties...)
• Lack of digital skills
• Visual problems that prevent exercise with the phone screen