Effects of Tele-rehabilitation Versus Supervised Rehabilitation Among Computer Users With Non-specific Neck Pain

Effects of Tele-rehabilitation Versus Supervised Rehabilitation on Neck Pain, Disability and Exercise Adherence Among Computer Users With Non-specific Neck Pain: A Randomized Controlled Trial

The current study is a single-blinded, two-arm parallel-group randomized controlled trial involving 62 participants with non-specific neck pain among computer users. The trial aims to compare the effects of tele-rehabilitation and supervised rehabilitation on neck pain, disability, and exercise adherence. Both groups will receive the same structured exercise program along with postural correction instructions. The tele-rehabilitation group will perform exercises remotely with digital guidance, reminders, and follow-ups, while the supervised group will receive in-clinic physiotherapy sessions under professional supervision. Interventions will be carried out three times per week for a duration of six weeks, with each session lasting approximately 40 minutes. Outcome measures will include neck pain (VAS), neck disability (NDI), and exercise adherence (ATEMPT tool).Assessments will be conducted at baseline and at the end of treatment at 8th week.The study will be conducted at the Physical Therapy Department of Sehat Medical Complex Lake City, and the University of Lahore Teaching Hospital. The hypothesis is that tele-rehabilitation will be more effective than supervised rehabilitation in reducing neck pain and disability, and may result in better exercise adherence due to its convenience and accessibility.

Study Overview

• Status: Not yet recruiting
• Conditions: Non Specific Neck Pain
• Intervention / Treatment: Other: Neck and upper back strengthening exercises by Tele-rehabilitation Intervention; Other: Neck and upper back strengthening by Supervised Rehabilitation Intervention

Detailed Description

Non-specific neck pain (NSNP) is a significant medical and socioeconomic issue, particularly among computer users who maintain prolonged static postures. For these professionals, time poverty due to hectic schedules serves as a primary barrier to recovery and exercise adherence. While conventional supervised rehabilitation is effective, it often requires frequent in-person visits that can limit accessibility. This study will evaluate the effectiveness of a tele-rehabilitation delivery model compared to traditional supervised care in improving neck pain, disability, and exercise adherence. The research uses a single-blinded, two-arm, parallel-group randomized clinical trial design.

Tele-rehabilitation Group (TG): Participants receive a digital postural instruction chart and a structured exercise program. Adherence is reinforced through daily WhatsApp notifications and monitored via digital confirmations.

Supervised Rehabilitation Group (SG): Participants receive the same exercise protocol and postural instructions but under the direct supervision of a qualified physiotherapist at a clinic. Both interventions are conducted three times a week for 6 weeks, with each session lasting approximately 30 minutes. The study will target 62 computer users aged 18-35 who work more than 35 hours per week and have experienced neck pain for at least 12 weeks.

Assessments will be conducted at baseline and every two weeks using the Visual Analogue Scale (VAS) for pain, the Neck Disability Index (NDI), and the Adherence To Exercise for Musculoskeletal Pain Tool (ATEMPT). The study aims to validate a clinic-to-desk model that eliminates geographical and time constraints, potentially reducing work absenteeism and improving the long-term health of the workforce.

• Study Type: Interventional
• Enrollment (Estimated): 62
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ammara Shamoon, MSPT; Phone Number: 03000089740; Email: MSPT243030@ubas.edu.pk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age 18-35 years.
• Neck pain that worsens with movement in at-least one direction
• Computer users with neck pain for at-least 12 weeks
• Neck pain with Visual Analog score of 3 to 8 out of 10
• Participants with forward head posture (FHP)
• Working >35h per week at a desk or computer in a sedentary manner

Exclusion Criteria:

• Individuals with any neurological or vascular disease
• A history of shoulder or spine injuries or surgeries
• Participants with history of regular participation or training programs
• Participants with body mass index over 30
• Participants having undergone physical therapy or other medical treatments for neck pain in the previous 6 months

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Telerehabilitation Group; Participants in the tele-rehabilitation group will receive exercise reminders and instructions digitally via WhatsApp reminders.	Other: Neck and upper back strengthening exercises by Tele-rehabilitation Intervention; Interventions (Postural Awareness, Neck and Upper Back strengthening exercises via Whatsapp reminders).Although both neck and upper back strengthening exercises have demonstrated potential effects individually, there is a paucity of research evaluating their combined effects. A structured program combining both exercises may produce improvements in pain, disability and greater exercise adherence rates when delivered digitally.
Active Comparator: Supervised Rehabilitation Group; Participants in the Supervised Rehabilitation group will receive the same protocol as the tele-rehabilitation group in the clinic under the supervision of a physiotherapist.	Other: Neck and upper back strengthening by Supervised Rehabilitation Intervention; Interventions ((Postural Awareness, Neck and Upper Back strengthening exercises under supervision) Participants in this group will receive the same 40 -minute session consisting of same exercises as the tele-rehabilitation group in the clinic under the supervision of a physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck Pain	Neck pain will be assessed using the visual analog scale (VAS). The VAS, widely regarded as one of the most reliable and validated methods for self-reporting pain intensity, uses a 10 cm horizontal line. On this scale, 0 cm indicates "no pain," while 10 cm represents "worst pain".	From enrollment to the end of treatment at 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Disability	The neck disability level will be determined using the Neck Disability Index (NDI), English version. This self-reporting questionnaire determines the disability index of the cervical spine and its impact on daily activities. The NDI has been validated as an effective evaluative tool for patients with neck pain. Each item is scored out of five (with the 'no disability' response given a score of 0), giving a total score for the questionnaire out of 50. Higher scores represent greater disability.	From enrollment to the end of treatment at 8 weeks
Exercise Adherence	Exercise adherence will be measured by using tool "Adherence To Exercise for Musculoskeletal Pain Tool (ATEMPT)". It is the first measure of adherence to exercise for MSK pain. ATEMPT is a uni-dimensional measure that contains six items from the six domains of exercise adherence. The 6-item version of the measure (scored 6-30). Each of the 6 items is scored on a 5-point Likert scale: Strongly Disagree = 1, Disagree = 2, Neither Agree nor Disagree = 3, Agree = 4, Strongly Agree = 5. Sum the scores from all 6 items to get a total between 6 (lowest adherence) and 30 (highest adherence). Higher scores (closer to 30) suggest better adherence to exercise, while lower scores (closer to 6) suggest poorer adherence.	From enrollment to the end of treatment at 8 weeks

Collaborators and Investigators

• Sponsor: Lahore University of Biological and Applied Sciences
• Investigators: Principal Investigator: Muhammad Tariq Rafiq, PhD, Lahore University of Biological & Applied Sciences

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: April 22, 2026
• First Submitted That Met QC Criteria: April 22, 2026
• First Posted (Actual): April 29, 2026

Study Record Updates

• Last Update Posted (Actual): April 29, 2026
• Last Update Submitted That Met QC Criteria: April 22, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Telerehabilitation; Neck pain; Exercise adherence; Supervised exercise therapy; Computer users; Musculoskeletal pain assessment tool
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neck Pain
• Other Study ID Numbers: UBAS/ERB/26/04/033

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Only IPD used in the results publication will be shared.
• IPD Sharing Time Frame: It will be available after the completion of the study.
• IPD Sharing Access Criteria: Through the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

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