Telerehabilitation Program in Lumbar Disc Herniation

Development of a Telerehabilitation-Based Exercise and Monitoring Program and Its Effectiveness Compared With a Brochure-Based Home Exercise Program in Patients With Lumbar Disc Herniation: A Randomized Controlled Trial

The aim of this study was to develop an asynchronous, web-based telerehabilitation exercise and monitoring program and to compare its effectiveness with a traditional brochure-based home exercise program in patients with lumbar disc herniation. The study was designed as a randomized controlled trial including 46 participants who were allocated into two groups: a telerehabilitation group and a brochure-based exercise group.

Both groups participated in a structured 4-week home exercise program. The telerehabilitation group received exercise guidance and follow-up through a web-based digital platform, which enabled remote monitoring of exercise adherence and patient-reported outcomes. The brochure group performed the same exercises using printed instructional materials.

Participants were evaluated before and after the intervention using standardized and validated assessment tools, including the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI) for functional disability, the SF-12 for quality of life, and tests for static and dynamic lumbar muscle strength and endurance.

Study Overview

• Status: Completed
• Conditions: Lumbar Disc Herniation
• Intervention / Treatment: Other: Web-Based Telerehabilitation Exercise Program; Other: Brochure-Based Home Exercise Program

Detailed Description

his study is a randomized controlled clinical trial designed to compare two different delivery methods of a home-based exercise program in patients diagnosed with lumbar disc herniation. The primary focus of the study is to evaluate the effectiveness of a web-based telerehabilitation exercise and monitoring program compared with a traditional brochure-based home exercise program.

A total of 46 eligible participants are randomly assigned into two groups: a telerehabilitation group and a brochure-based exercise group. Both groups follow the same structured home exercise program for a duration of four weeks, consisting of standardized exercises performed three times per week.

Participants in the telerehabilitation group access exercise instructions through a web-based digital platform that includes video demonstrations, written guidance, and remote monitoring features. The platform allows participants to record their exercise sessions and enables physiotherapists to monitor adherence and provide feedback when necessary. The intervention is delivered asynchronously, without real-time interaction.

Participants in the brochure group receive printed materials containing the same exercises, including visual and written instructions. Initial instruction is provided face-to-face, after which participants continue the exercise program independently at home.

Outcome assessments are conducted before and after the intervention by a physiotherapist who is blinded to group allocation. Evaluations include pain intensity, functional disability, quality of life, and lumbar muscle strength and endurance, using standardized and validated measurement tools.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Meram
    • Konya, Meram, Turkey (Türkiye), 42090
      • Necmettin Erbakan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Aged between 18 and 65 years
• Diagnosed with lumbar disc herniation by a specialist physician
• Presence of bulging or protrusion stage lumbar disc herniation
• Willing to participate and provide informed consent
• Having basic smartphone or computer skills and access to the internet (for the telerehabilitation group

Exclusion Criteria:

• History of spinal surgery
• Presence of extruded or sequestered lumbar disc herniation
• Visual or hearing impairment that may affect participation
• Presence of spinal tumors
• Communication or cognitive problems preventing participation
• Inability to understand Turkish

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Telerehabilitation Group; Participants received a web-based telerehabilitation exercise and monitoring program including video-guided exercises, remote monitoring of adherence, and asynchronous follow-up via a digital platform.	Other: Web-Based Telerehabilitation Exercise Program; Participants performed a structured home exercise program delivered through a web-based telerehabilitation platform. The program included video-guided exercises, written instructions, and asynchronous remote monitoring. Participants recorded their exercise sessions, and physiotherapists monitored adherence and provided feedback through the digital system. The intervention was conducted for 4 weeks, 3 days per week, with 3 sets of 10 repetitions for each exercise.
Active Comparator: Brochure Group; Participants received a brochure-based home exercise program including printed instructions and visual materials, with initial face-to-face instruction and no remote monitoring.	Other: Brochure-Based Home Exercise Program; Participants performed the same structured home exercise program using printed brochures that included visual and written instructions. Exercises were initially demonstrated face-to-face, and participants continued independently at home without remote monitoring. The program was applied for 4 weeks, 3 days per week, with 3 sets of 10 repetitions for each exercise.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity assessed by Visual Analog Scale (VAS)	Pain intensity assessed by the Visual Analog Scale (VAS) Pain intensity measured using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain severity. The assessment includes overall pain, pain at rest, pain during activity, and night pain. [Time Frame: Baseline and after 4 weeks]Pain intensity measured using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain severity. The assessment includes overall pain, pain at rest, pain during activity, and night pain.	Baseline and after 4 weeks
Functional disability (ODI)	Functional disability assessed by the Oswestry Disability Index (ODI) Functional disability measured using the Oswestry Disability Index (ODI), a questionnaire consisting of 10 items scored from 0 to 5, with a total score ranging from 0 to 50. Higher scores indicate greater disability.	Baseline and after 4 weeks
Quality of life (SF-12)	Quality of life assessed by the 12-Item Short Form Health Survey (SF-12) Quality of life measured using the 12-Item Short Form Health Survey (SF-12), which generates physical (PCS) and mental (MCS) component summary scores ranging from 0 to 100. Higher scores indicate better health-related quality of life.	Baseline and after 4 weeks
Static trunk muscle endurance	Static trunk muscle endurance assessed using Diener's trunk muscle test Static trunk muscle endurance measured using Diener's (1992) trunk muscle test, expressed as the duration (seconds) the participant maintains the trunk flexion position until the inferior angle of the scapula lifts off the surface. The maximum score is 30 seconds. Higher values indicate greater trunk muscle endurance.	Baseline and after 4 weeks
Dynamic trunk muscle endurance	Dynamic trunk muscle endurance assessed using Diener's trunk muscle test Dynamic trunk muscle endurance measured using Diener's (1992) trunk muscle test, expressed as the number of complete trunk flexion repetitions performed within 30 seconds. Higher values indicate greater trunk muscle endurance.	Baseline and after 4 weeks

Collaborators and Investigators

• Sponsor: Necmettin Erbakan University

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2024
• Primary Completion (Actual): June 1, 2024
• Study Completion (Actual): September 1, 2024

Study Registration Dates

• First Submitted: March 19, 2026
• First Submitted That Met QC Criteria: March 25, 2026
• First Posted (Actual): March 30, 2026

Study Record Updates

• Last Update Posted (Actual): March 30, 2026
• Last Update Submitted That Met QC Criteria: March 25, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Digital Health; Exercise Adherence; Lumbar Disc Herniation; Digital Rehabilitation; Patient Monitoring Systems
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Pathological Conditions, Anatomical; Spinal Diseases; Hernia; Pathological Conditions, Signs and Symptoms; Intervertebral Disc Displacement
• Other Study ID Numbers: NEU-PT2025-05; 24YL30002 (Other Identifier: Necmettin Erbakan University Scientific Research Projects Coordinatorship)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be publicly shared due to privacy and confidentiality concerns. The data contain potentially identifiable information and are protected under ethical and institutional regulations. However, de-identified data may be made available from the corresponding author upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No