Comparison of the effectiveness of exercise, manual therapy and telerehabilitation assisted therapy on pain, anxiety and quality of life in degenerative cervical diseases

The aim of this study was to compare the effectiveness of exercise program, manual therapy and telerehabilitation assisted treatment on pain, anxiety and quality of life in cervical degenerative patients. A total of 75 volunteers with degenerative cervical problems who met the research criteria were included in the study. At the end of the six-month follow-up, the study was completed with a total of 66 participants. The patients were divided into 3 groups by simple random randomization method: home exercise group (EG), manual therapy (MT) group and telerehabilitation (TR) group. A total of 75 volunteers with degenerative cervical problems who met the research criteria were included in the study. At the end of the six-month follow-up, the study was completed with a total of 66 participants. The patients were divided into 3 groups by simple randomization method: home exercise group (EG), manual therapy (MT) group and telerehabilitation (TR) group. All patients were initially taught the exercises face-to-face. TR group patients were asked to do exercises with telerehabilitation support and active mobilizations at home, accompanied by a physiotherapist, 2 days a week for 8 weeks, as well as the exercises given in EG. Pain (Visual pain scale (VAS) and McGill pain index), pressure pain threshold, muscle strength, hand grip strength, scapular dyskinesia, neck disability, cervical and shoulder range of motion, head posture, scapular dyskinesia, box-block hand skill test, Nottingham health profile, quality of life, anxiety and patient satisfaction levels were evaluated by the physiotherapist by calling the patients to the clinic. Findings, significant differences were found in the parameters of pain, neck disability, anxiety sensitivity, ROM, upper extremity strength, pressure pain threshold, scapular dyskinesia in all three groups (p<0.05). While there was a significant decrease in the McGill pain index in the TR and MT groups (p<0.05); No significant difference was observed in EG. Pain reduction was observed at the end of the treatment in the MT group and at the 3rd and 6th months after the treatment in the TR group. Improvement in head posture was found to be significant only in the TR group (p<0.05). While the pressure pain threshold increased significantly in all groups (p<0.05), the highest increase was found in the MT group. While the mean patient satisfaction was found to be highest in the MT group (p<0.05) and lowest in the EG group, there was no difference between the TR and MT groups (p>0.05). As a result of the study, it was seen that exercise, cervical and thoracic mobilization and active mobilization treatments supported by telerehabilitation were effective in degenerative cervical disease. Considering the follow-up of the patients and their long-term effects, it was concluded that telerehabilitation-supported active manual therapy and exercise can be included in rehabilitation programs in the presence of problems such as pandemics and transportation problems.