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FOTO Rehab Outcomes Blog

Effectiveness of Telehealth-based Interventions for Individuals with Low Back Pain



Although technology can be exciting to use, we need to know the impact technology may have on our patients. What changes if telemedicine is brought into the picture as the intervention of choice for individuals who have non-specific low back pain?

Since apps and telemedicine are fairly new and could definitely be an option to substantially reduce the cost of care, time needs to be spent determining if this care option is beneficial. It doesn't appear that rehabilitation professionals will be replaced by an app, based on the abstract below. I'd be curious if the app falls along the same lines as an educational booklet. 

Below you will find a quick view of the abstract. 


Effectiveness of telehealth-based interventions in the management of non-specific low back pain: a systematic review with meta-analysis.




Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP), however its effectiveness has not been investigated.


The aim of this review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP.


Systematic review with meta-analysis METHODS: Seven databases were searched from the earliest records to August 2015. Eligible studies were randomized controlled trials that investigated the effectiveness of telehealth-based interventions, solo or in combination with other interventions, for non-specific LBP compared to a control group. Trials deemed clinically homogeneous were grouped in meta-analyses.


Eleven studies were included (N = 2280). In chronic LBP, telehealth interventions had no significant effect on pain at short [four trials; 1,089 participants; weighted mean difference (WMD) -2.61 points; 95% CI: -5.23 to 0.01] or medium-term follow-up (two trials; 441 participants; WMD: -0.94 points; 95% CI: -6.71 to 4.84) compared to a control group. Similarly, there was no significant effect for disability. Results from three individual trials showed that telehealth was superior to a control intervention for improving quality of life. Interventions combining telehealth and usual care were more beneficial than usual care alone in people with recent onset of LBP symptoms.


There is moderate-quality evidence that current telehealth interventions, alone, are not more effective than minimal interventions for reducing pain and disability in chronic LBP. To date, modern telehealth media (e.g. apps) and telehealth as an adjunct to usual care remain understudied.

2017 Apr 13. pii: S1529-9430(17)30142-0. doi: 10.1016/j.spinee.2017.04.008. [Epub ahead of print]