Shah Nidhi, Shetty Gautam M, Kanna Raj, Thakur Harshad
National Clinical Expert & Senior Spine Physiotherapist, QI Spine Clinic, Mumbai, India.
Consultant Orthopaedic Surgeon and Head of Reseach, QI Spine Clinic, Mumbai, India.
Disabil Rehabil Assist Technol. 2024 Apr;19(3):558-565. doi: 10.1080/17483107.2022.2107718. Epub 2022 Aug 5.
Despite increased usage of telemedicine to deliver treatment during the coronavirus disease 2019 (COVID-19) pandemic, the efficacy of telerehabilitation for spine pain is unknown. This study aimed to investigate the effect of telerehabilitation on pain and disability in patients with spine pain treated during the COVID-19 pandemic and compare the results to in-clinic rehabilitation.
MATERIALS & METHODS: In this propensity score-matched analysis, 428 patients with spine pain who underwent telerehabilitation during the 6 months of COVID-19 pandemic lockdown and 428 patients who underwent in-clinic multimodal rehabilitation treatment during the 6-month period prior to lockdown were compared. Propensity score matching was done based on gender, age, pre-treatment pain, and disability. Post-treatment numerical pain rating scale (NPRS), Oswestry or Neck disability index (ODI or NDI), and minimal clinical important difference (MCID) achieved for NPRS and ODI/NDI scores were compared between the 2 groups.
Post-treatment, the mean NPRS (mean difference - 1, < 0.0001) and ODI/NDI (mean difference - 5.8, < 0.0001) scores, were significantly lower in the telerehabilitation group when compared to control group. Similarly, the percentage of patients who achieved MCID of ≥ 2 for NPRS (mean difference - 6%, = 0.0007) and MCID of ≥ 10 for ODI/NDI (mean difference - 7.5%, = 0.005) scores were significantly higher in the telerehabilitation group.
Telerehabilitation achieved significant reduction in pain and disability among patients with spine pain, better than in-clinic rehabilitation. These encouraging results during the COVID-19 pandemic indicate the need to further explore and test the efficacy and wider application of telerehabilitation for treating spine pain.IMPLICATIONS FOR REHABILITATIONTelerehabilitation can help achieve significant reduction in pain and disability among patients with spine pain.These encouraging results indicate the need to further explore a wider application of telerehabilitation for treating patients with spine pain during non-pandemic times.
尽管在2019年冠状病毒病（COVID-19）大流行期间远程医疗用于提供治疗的情况有所增加，但远程康复治疗脊柱疼痛的疗效尚不清楚。本研究旨在调查远程康复对COVID-19大流行期间接受治疗的脊柱疼痛患者疼痛和残疾状况的影响，并将结果与门诊康复进行比较。
在这项倾向评分匹配分析中，比较了428例在COVID-19大流行封锁的6个月期间接受远程康复的脊柱疼痛患者和428例在封锁前6个月期间接受门诊多模式康复治疗的患者。倾向评分匹配基于性别、年龄、治疗前疼痛和残疾状况进行。比较两组治疗后数字疼痛评分量表（NPRS）、奥斯维斯特或颈部残疾指数（ODI或NDI）以及NPRS和ODI/NDI评分达到的最小临床重要差异（MCID）。
治疗后，与对照组相比，远程康复组的平均NPRS（平均差值 -1，<0.0001）和ODI/NDI（平均差值 -5.8，<0.0001）评分显著更低。同样，NPRS达到MCID≥2的患者百分比（平均差值 -6%，=0.0007）和ODI/NDI达到MCID≥10的患者百分比（平均差值 -7.5%，=0.005）在远程康复组中显著更高。
远程康复使脊柱疼痛患者的疼痛和残疾状况显著减轻，优于门诊康复。在COVID-19大流行期间这些令人鼓舞的结果表明，需要进一步探索和测试远程康复治疗脊柱疼痛的疗效及更广泛应用。
对康复的启示
远程康复有助于显著减轻脊柱疼痛患者的疼痛和残疾状况。
这些令人鼓舞的结果表明，有必要进一步探索在非大流行时期更广泛地应用远程康复来治疗脊柱疼痛患者。
