Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Mar 26, 2025
Date Accepted: Jun 2, 2025
Internet-based Telerehabilitation vs In-person Therapeutic Exercises in Young Adult Females with Chronic Neck Pain and Forward Head Posture: Randomized Controlled Trial
ABSTRACT
Background:
Neck pain is a common musculoskeletal disorder, often linked to forward head posture (FHP). Studies have shown that exercise interventions can improve pain, craniovertebral angle (CVA), range of motion, and function in individuals with FHP. While telerehabilitation exercise has proven effective for other musculoskeletal conditions, its effectiveness in addressing neck pain and FHP is still being investigated.
Objective:
This study evaluated the effectiveness of a telerehabilitation therapeutic exercise program delivered via real-time videoconferencing for young adult females with chronic non-specific neck pain and FHP.
Methods:
A randomized controlled trial was conducted with 50 participants experiencing chronic neck pain and FHP. Participants were randomly assigned to either a telerehabilitation group or an in-person supervision group. Both groups underwent an identical six-week therapeutic exercise program, supervised through either real-time video sessions or in-person sessions. Outcome measures, including pain intensity (Visual Analog Scale, VAS), CVA, neck disability (Neck Disability Index, NDI), and cervical range of motion (CROM), were assessed at baseline, after four and six weeks of intervention, and at a two-week follow-up.
Results:
No significant interaction effect between group and time was observed. However, a significant main effect of time demonstrated improvements in all variables, including reductions in pain intensity (VAS) and enhancements in CVA, NDI, and CROM (P < .001), across both intervention groups.
Conclusions:
Both telerehabilitation and in-person supervision effectively improved pain, posture, neck disability, and cervical range of motion in young adult females with chronic neck pain and FHP. The findings highlight that telerehabilitation offers a convenient, accessible, and equally effective alternative to traditional in-person therapeutic exercise programs for managing chronic neck pain. Clinical Trial: The study protocol received approval from the Human Research Ethics Committee at Walailak University, Thailand (Approval number: WUEC-23-335-02), and the trial was registered with the Thai Clinical Trials Registry (Registration number: TCTR20240326007).
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