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.
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
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
Parallel
Neck and upper back strengthening exercises by Tele-rehabilitation Intervention
Other interventionInterventions (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.
Neck and upper back strengthening by Supervised Rehabilitation Intervention
Other interventionInterventions ((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.
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".
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.
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.
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