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Effects of Clinical Based Versus Synchronized Telerehabilitation on Pain, Exercise Adherence, and Functional Disability Among Patients With Grade-II Cervical Spondylosis.

25. juni 2026 opdateret af: Dr. Khizra Hamid, Lahore University of Biological and Applied Sciences
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.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

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

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

52

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of biological and applied sciences

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • 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

Exclusion Criteria:

  • 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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Group A: Clinical Based Rehabilitation
Participants in Group A will receive clinical-based rehabilitation through in-person physiotherapy sessions in an outpatient setting. Treatment will be delivered three times per week for 6 weeks, with each session lasting approximately 30-40 minutes. All interventions will be provided under the direct supervision of a qualified physiotherapist, ensuring proper monitoring, guidance, and correction of patient performance during therapy sessions. Participants will also receive standardized instructions for home-based continuation of care on non-supervised days to support consistency of rehabilitation. The focus of this arm is to evaluate the effectiveness of traditional face-to-face physiotherapy care in improving pain, functional disability, and exercise-related outcomes in patients with Grade-II cervical spondylosis.
Andet: Group A: Clinical Based Rehabilitation
The first intervention is clinical-based rehabilitation, delivered through in-person physiotherapy sessions in an outpatient clinical setting. Participants will receive supervised treatment three times per week for 6 weeks, with each session lasting approximately 30-40 minutes. All sessions will be conducted by a qualified physiotherapist who will provide direct monitoring, guidance, and correction to ensure proper execution of therapy. This conventional rehabilitation approach emphasizes face-to-face interaction, allowing individualized attention and real-time clinical decision-making. Participants will also be advised to continue prescribed home-based activities on non-session days to maintain consistency and support recovery outcomes.
Aktiv komparator: Group B: Synchronized Telerehabilitation
Participants in Group B will receive synchronized telerehabilitation delivered through real-time video conferencing. Sessions will be conducted three times per week for 6 weeks, with each session lasting approximately 30-40 minutes. Rehabilitation will be supervised live by a qualified physiotherapist who will provide instruction, monitoring, and feedback during each session to ensure correct performance and safety. This remote delivery model will replicate the structure of clinical-based rehabilitation while eliminating the need for in-person visits. Participants will also be given standardized guidance for continuing home-based activities on non-session days. This arm aims to evaluate the effectiveness of synchronized telehealth-based physiotherapy in improving pain, functional disability, and exercise adherence in patients with Grade-II cervical spondylosis.
Andet: Group B: Synchronized Telerehabilitation
The second intervention is synchronized telerehabilitation, delivered through real-time video conferencing sessions. Participants will receive supervised physiotherapy remotely three times per week for 6 weeks, with each session lasting approximately 30-40 minutes. A qualified physiotherapist will provide live instruction, monitoring, and feedback to ensure correct performance and safety during exercises. This approach replicates the structure of clinical-based rehabilitation while eliminating the need for in-person visits. Participants will also be given standardized home-based activity instructions for non-session days to maintain continuity of care. The intervention aims to evaluate the effectiveness of remote, technology-based rehabilitation in improving clinical outcomes in patients with Grade-II cervical spondylosis.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain Intensity
Tidsramme: 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.
Measured at baseline (pre-intervention) and after 6 weeks (post-intervention completion).
Functional Disability
Tidsramme: 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.
Measured at baseline (pre-intervention) and at 6 weeks post-intervention completion.
Exercise Adherence
Tidsramme: 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.
Measured at baseline and at 6 weeks post-intervention completion.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Lahore University of Biological and Applied Sciences

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

1. oktober 2026

Studieafslutning (Anslået)

30. november 2026

Datoer for studieregistrering

Først indsendt

25. juni 2026

Først indsendt, der opfyldte QC-kriterier

25. juni 2026

Først opslået (Faktiske)

1. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juni 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • UBAS/ERB/26/04/034

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

baseline participants

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

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