Six-month follow-up results of clinic- and telerehabilitation-based motor control exercises in individuals with chronic low back pain: A randomized controlled trial

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide. Motor control exercises (MCE) are considered effective in its management. The COVID-19 accelerated the use of telerehabilitation (TR), yet its long-term effectiveness compared to clinic-based (CB) approaches remains insufficiently studied. Aims: To compare 6-month outcomes of TR-based (TR-B) and CB MCE programs in individuals with CLBP. Primary outcome was pain; secondary outcomes included disability, quality of life, catastrophizing, gait parameters, lumbar flexion range of motion (ROM), satisfaction, and perceived treatment effect. Methods: This study was previously published for its initial effects; this manuscript presents the long-term follow-up results. Forty-two individuals with CLBP were randomized to receive either CB or TR-B MCE, performed three times weekly for eight weeks. Both groups received an initial face-to-face session for deep muscle activation. Outcome assessments were conducted at baseline, post-intervention, and at 6 months. Analyses were performed using both per-protocol (P-P) and intention-to-treat (ITT) approaches. Results: Both groups showed significant improvements in pain, disability, quality of life, and pain catastrophizing (p < 0.05), with no significant between-group differences (p > 0.05), except for lumbar flexion ROM at 6 months (p < 0.05). Gait parameters did not significantly change. Satisfaction and perceived treatment benefits were similarly high in both groups. However, follow-up adherence was lower in the TR-B group. Conclusion: TR-B MCE are comparable to CB interventions in improving key clinical outcomes in CLBP. TR may require additional interactive components to support long-term engagement. These results highlight TR’s potential as an effective and accessible component of CLBP management.