Efeito de programa de telerreabilitação versus cartilha de autocuidado na dor e incapacidade funcional de pacientes com dor cervical crônica não especifica: um ensaio clínico controlado, simples cego com 3 meses de seguimento

Abstract

Introduction: Neck pain is a common disabling condition that directly affects the performance of daily life activities and participation in professional, social and sports activities, being one of the main causes of functional disability in the world. Telerehabilitation-based treatments have demonstrated their importance due to their ease of use, low cost and their tendency to improve clinical outcomes. However, in the current scientific evidence, there is a lack of studies that exemplify telerehabilitation protocols in individuals with chronic non-specific neck pain. Thus, the aim of this study was to verify the effect of a telerehabilitation protocol versus an online self-care booklet in individuals with non-specific chronic neck pain. Method: This is a blinded, randomized controlled clinical trial that compares a telerehabilitation program for neck pain with a control group that will receive an online self-care booklet. Seventy patients were recruited by telephone from the waiting list at the clinical school of a public university, in addition to wide dissemination on social networks. For this purpose, assessments and follow-ups were carried out completely remotely, through online platforms (Google Meet, smartphone messages, email) and telephone calls. The primary outcome was functional disability measured by the Neck Disability Index questionnaire consisting of 10 items. Secondary outcomes were pain intensity measured using the numeric rating scale, perceived global effect measured using the global effect scale perceived, patient self-efficacy using the Chronic Pain Self Efficacy Scale, quality of life using the SF-12, and kinesiophobia through the Tampa Scale of Kinesiophobia. Measures were assessed at baseline, 6 weeks, and 3 months after randomization. Outcomes: There was a significant difference between groups for the variables functional disability (Mean 10.32, 95% CI 4.84 to 15.79), pain intensity (Mean 2.80, 95% CI 1.40 to 4.19), effect perceived global (Mean -2.38, 95% CI -3.77 to -0.98) and self-efficacy (Mean -24.75, 95% CI -41.09 to -8.41) within 6 weeks of randomization. At 3 months only for the variables perceived global effect (Mean -2.00, 95% CI -3.40 to -0.60) and self-efficacy (Mean -26.31, 95% CI -42.82 to -9.80). Conclusion: Telerehabilitation is effective for reducing disability and pain, gain in perceived global effect and self-efficacy after treatment, and at 3 months for gain in perceived global effect and self-efficacy.