{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:43:12Z","timestamp":1792626192693,"version":"4.5.0"},"reference-count":47,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Physical therapy has demonstrated efficacy in managing nonspecific low back pain (NLBP) among patients. Nevertheless, the prevalence of NLBP poses a challenge, as the existing medical infrastructure may be insufficient to care for the large patient population, particularly in geographically remote regions. Telerehabilitation emerges as a promising method to address this concern by offering a method to deliver superior medical care to a greater number of patients with NLBP.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The purpose of this study is to demonstrate the physical and psychological effectiveness of a user-centered telerehabilitation program, consisting of a smartphone app and integrated sensors, for patients with NLBP.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This was a single-center, prospective, randomized controlled trial for individuals with NLBP for a duration exceeding 3 months. All participants were assigned randomly to either the telerehabilitation-based exercise group (TBEG) or the outpatient-based exercise group (OBEG). All participants completed a 30-minute regimen of strength and stretching exercises 3 times per week, for a total of 8 weeks, and were required to complete assessment questionnaires at 0, 2, 4, and 8 weeks. The TBEG completed home-based exercises and questionnaires using a telerehabilitation program, while the OBEG completed them in outpatient rehabilitation. The Oswestry Disability Index (ODI) served as the primary outcome measure, assessing physical disability. Secondary outcomes included the Numeric Pain Rating Scale, Fear-Avoidance Beliefs Questionnaire, and 36-item Short-Form Health Survey.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 54 of 129 eligible patients were enrolled and randomly assigned to the study. The completion of all the interventions and assessments in the TBEG and OBEG was 89% (24\/27) and 81% (22\/27). The findings indicate that no statistical significance was found in the difference of ODI scores between the TBEG and the OBEG at 2 weeks (mean difference \u22120.91; odds ratio [OR] 0.78, 95% CI \u22125.96 to 4.14;\n P<\/jats:italic>\n =.72), 4 weeks (mean difference \u22123.80; OR 1.33, 95% CI \u22129.86 to \u22122.25;\n P<\/jats:italic>\n =.21), and 8 weeks (mean difference \u22123.24; OR 0.92, 95% CI \u22128.65 to 2.17;\n P<\/jats:italic>\n =.24). The improvement of the ODI in the TBEG (mean \u221216.42, SD 7.30) and OBEG (mean \u221213.18, SD 8.48) was higher than 10 after an 8-week intervention. No statistically significant differences were observed between the 2 groups at the 8-week mark regarding the Fear-Avoidance Beliefs Questionnaire (mean difference 8.88; OR 1.04, 95% CI \u22122.29 to 20.06;\n P<\/jats:italic>\n =.12) and Numeric Pain Rating Scale (mean difference \u22120.39; OR 0.44, 95% CI \u22122.10 to 1.31;\n P<\/jats:italic>\n =.64). In the subgroup analysis, there was no statistically significant difference in outcomes between the 2 groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Telerehabilitation interventions demonstrate comparable therapeutic efficacy for individuals with NLBP when compared to conventional outpatient-based physical therapy, yielding comparable outcomes in pain reduction and improvement in functional limitations.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/56580","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T19:04:24Z","timestamp":1720551864000},"page":"e56580-e56580","source":"Crossref","is-referenced-by-count":28,"title":["The Physical and Psychological Effects of Telerehabilitation-Based Exercise for Patients With Nonspecific Low Back Pain: Prospective Randomized Controlled Trial"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2101-3134","authenticated-orcid":false,"given":"Weihong","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6021-3276","authenticated-orcid":false,"given":"Yuhang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4676-8926","authenticated-orcid":false,"given":"Yanyan","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-9094","authenticated-orcid":false,"given":"Lixia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-0929","authenticated-orcid":false,"given":"Wangshu","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-4044","authenticated-orcid":false,"given":"Houqiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3190-8713","authenticated-orcid":false,"given":"Qiyang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1322-9190","authenticated-orcid":false,"given":"Huiling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-0098","authenticated-orcid":false,"given":"Diana","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-9042","authenticated-orcid":false,"given":"Ye","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"issue":"10070","key":"R1","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","journal-title":"Lancet"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"5","author":"GBD 2021 Low Back Pain Collaborators","journal-title":"Lancet Rheumatol"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/j.pain.0000000000001396","article-title":"The prevalence and years lived with disability caused by low back pain in China, 1990 to 2016: findings from the Global Burden of Disease Study 2016","volume":"160","author":"Wu","journal-title":"Pain"},{"issue":"6","key":"R4","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1136\/annrheumdis-2013-204428","article-title":"The global burden of low back pain: estimates from the Global Burden of Disease 2010 study","volume":"73","author":"Hoy","journal-title":"Ann Rheum Dis"},{"issue":"10267","key":"R5","doi-asserted-by":"publisher","first-page":"2006","DOI":"10.1016\/S0140-6736(20)32340-0","article-title":"Global estimates of the need for rehabilitation based on the Global Burden of Disease Study 2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Cieza","journal-title":"Lancet"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1038\/s41572-018-0052-1","article-title":"Low back pain","volume":"4","author":"Vlaeyen","journal-title":"Nat Rev Dis Primers"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6748","article-title":"Low back pain and sciatica: summary of NICE guidance","volume":"356","author":"Bernstein","journal-title":"BMJ"},{"issue":"10137","key":"R8","doi-asserted-by":"publisher","first-page":"2368","DOI":"10.1016\/S0140-6736(18)30489-6","article-title":"Prevention and treatment of low back pain: evidence, challenges, and promising directions","volume":"391","author":"Foster","journal-title":"Lancet"},{"issue":"7","key":"R9","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/j.spinee.2020.04.006","article-title":"Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain","volume":"20","author":"Kreiner","journal-title":"Spine J"},{"issue":"45","key":"R10","doi-asserted-by":"publisher","first-page":"E1386","DOI":"10.1503\/cmaj.170527","article-title":"Diagnosis and management of low-back pain in primary care","volume":"189","author":"Traeger","journal-title":"CMAJ"},{"issue":"4","key":"R11","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.jphys.2021.09.004","article-title":"Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis","volume":"67","author":"Hayden","journal-title":"J Physiother"},{"issue":"2","key":"R12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.rehab.2016.01.009","article-title":"Barriers to home-based exercise program adherence with chronic low back pain: patient expectations regarding new technologies","volume":"59","author":"Palazzo","journal-title":"Ann Phys Rehabil Med"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/53262","article-title":"mHealth apps for the self-management of low back pain: systematic search in app stores and content analysis","volume":"12","author":"Zhou","journal-title":"JMIR Mhealth Uhealth"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2020.08.001","article-title":"Digital interventions for promoting exercise adherence in chronic musculoskeletal pain: a systematic review and meta-analysis","volume":"111","author":"Bunting","journal-title":"Physiotherapy"},{"issue":"12","key":"R15","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1080\/09593985.2018.1474402","article-title":"Patient adherence to an exercise program for chronic low back pain measured by patient-report, physiotherapist-perception and observational data","volume":"35","author":"Peek","journal-title":"Physiother Theory Pract"},{"issue":"6","key":"R16","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.20400","article-title":"Effect of an artificial intelligence-based self-management app on musculoskeletal health in patients with neck and\/or low back pain referred to specialist care: a randomized clinical trial","volume":"6","author":"Marcuzzi","journal-title":"JAMA Netw Open"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12916-022-02237-z","article-title":"Multimorbidity and co-occurring musculoskeletal pain do not modify the effect of the SELFBACK app on low back pain-related disability","volume":"20","author":"\u00d8ver\u00e5s","journal-title":"BMC Med"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-018-0076-7","article-title":"Randomized controlled trial of a 12-week digital care program in improving low back pain","volume":"2","author":"Shebib","journal-title":"NPJ Digit Med"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0109-x","article-title":"App-based multidisciplinary back pain treatment versus combined physiotherapy plus online education: a randomized controlled trial","volume":"2","author":"Toelle","journal-title":"NPJ Digit Med"},{"issue":"6","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/15375","article-title":"The clinical and cost-effectiveness of telerehabilitation for people with nonspecific chronic low back pain: randomized controlled trial","volume":"8","author":"Fatoye","journal-title":"JMIR Mhealth Uhealth"},{"issue":"5","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/35867","article-title":"Evaluation of the effect of patient education and strengthening exercise therapy using a mobile messaging app on work productivity in Japanese patients with chronic low back pain: open-label, randomized, parallel-group trial","volume":"10","author":"Itoh","journal-title":"JMIR Mhealth Uhealth"},{"issue":"6","key":"R22","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1097\/j.pain.0000000000000146","article-title":"How does pain lead to disability? A systematic review and meta-analysis of mediation studies in people with back and neck pain","volume":"156","author":"Lee","journal-title":"Pain"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1016\/j.spinee.2013.09.036","article-title":"The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review","volume":"14","author":"Wertli","journal-title":"Spine J"},{"issue":"3","key":"R24","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/0304-3959(94)00279-N","article-title":"Fear of movement\/(re)injury in chronic low back pain and its relation to behavioral performance","volume":"62","author":"Vlaeyen","journal-title":"Pain"},{"issue":"8","key":"R25","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.1097\/j.pain.0000000000000574","article-title":"The fear-avoidance model of pain","volume":"157","author":"Vlaeyen","journal-title":"Pain"},{"issue":"9 Suppl","key":"R26","doi-asserted-by":"publisher","first-page":"T70","DOI":"10.1016\/j.jpain.2016.01.001","article-title":"The role of psychosocial processes in the development and maintenance of chronic pain","volume":"17","author":"Edwards","journal-title":"J Pain"},{"issue":"7","key":"R27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0180788","article-title":"Physical activity and the mediating effect of fear, depression, anxiety, and catastrophizing on pain related disability in people with chronic low back pain","volume":"12","author":"Marshall","journal-title":"PLoS One"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1093\/pm\/pnab318","article-title":"Changes in pain self-efficacy, coping skills, and fear-avoidance beliefs in a randomized controlled trial of yoga, physical therapy, and education for chronic low back pain","volume":"23","author":"Marshall","journal-title":"Pain Med"},{"issue":"10","key":"R29","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1001\/jama.295.10.1147","article-title":"Quality of reporting of noninferiority and equivalence randomized trials","volume":"295","author":"Le Henanff","journal-title":"JAMA"},{"issue":"12","key":"R30","doi-asserted-by":"publisher","first-page":"1734","DOI":"10.1089\/tmj.2021.0599","article-title":"Efficacy of e-Health interventions in patients with chronic low-back pain: a systematic review with meta-analysis","volume":"28","author":"Lara-Palomo","journal-title":"Telemed J E Health"},{"issue":"22","key":"R31","doi-asserted-by":"publisher","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"R32","first-page":"431","volume":"28","author":"Bombardier","journal-title":"J Rheumatol"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/0304-3959(93)90127-B","article-title":"A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability","volume":"52","author":"Waddell","journal-title":"Pain"},{"issue":"11","key":"R34","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1016\/s0895-4356(98)00105-x","article-title":"Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 Health Survey","volume":"51","author":"Lam","journal-title":"J Clin Epidemiol"},{"issue":"5","key":"R35","doi-asserted-by":"publisher","first-page":"32420712","DOI":"10.23736\/S1973-9087.20.06158-4","article-title":"Reliability, responsiveness and minimal clinically important difference of the two Fear Avoidance and Beliefs Questionnaire scales in Italian subjects with chronic low back pain undergoing multidisciplinary rehabilitation","volume":"56","author":"Monticone","journal-title":"Eur J Phys Rehabil Med"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.ejpain.2003.09.004","article-title":"Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale","volume":"8","author":"Salaffi","journal-title":"Eur J Pain"},{"issue":"9","key":"R37","doi-asserted-by":"publisher","first-page":"104559","DOI":"10.1016\/j.jpain.2024.104559","article-title":"Measurement error, minimal detectable change, and minimal clinically important difference of the Short Form-36 Health Survey, Hospital Anxiety and Depression Scale, and pain numeric rating scale in patients with chronic pain","volume":"25","author":"Gr\u00f6nkvist","journal-title":"J Pain"},{"issue":"6","key":"R38","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1177\/0962280216666564","article-title":"Multiple imputation by chained equations for systematically and sporadically missing multilevel data","volume":"27","author":"Resche-Rigon","journal-title":"Stat Methods Med Res"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/40844","article-title":"mHealth intervention for improving pain, quality of life, and functional disability in patients with chronic pain: systematic review","volume":"11","author":"Moreno-Ligero","journal-title":"JMIR Mhealth Uhealth"},{"issue":"10","key":"R40","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12101558","article-title":"App-based rehabilitation in back pain, a systematic review","volume":"12","author":"Stark","journal-title":"J Pers Med"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.2196\/48204","article-title":"Efficacy of mHealth interventions for improving the pain and disability of individuals with chronic low back pain: systematic review and meta-analysis","volume":"11","author":"de Melo Santana","journal-title":"JMIR Mhealth Uhealth"},{"issue":"21","key":"R42","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1136\/bjsports-2019-100886","article-title":"Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis","volume":"54","author":"Owen","journal-title":"Br J Sports Med"},{"issue":"17","key":"R43","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175510","article-title":"The role of back muscle dysfunctions in chronic low back pain: state-of-the-art and clinical implications","volume":"12","author":"Matheve","journal-title":"J Clin Med"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"71","DOI":"10.4085\/1062-6050-51.11.16","article-title":"Core stability exercise versus general exercise for chronic low back pain","volume":"52","author":"Coulombe","journal-title":"J Athl Train"},{"issue":"5","key":"R45","doi-asserted-by":"publisher","first-page":"647","DOI":"10.23736\/S1973-9087.17.05062-6","article-title":"Effect of stabilization exercise on back pain, disability and quality of life in adults with scoliosis: a systematic review","volume":"54","author":"Alanazi","journal-title":"Eur J Phys Rehabil Med"},{"issue":"8","key":"R46","doi-asserted-by":"publisher","first-page":"505","DOI":"10.2519\/jospt.2022.10671","article-title":"Best exercise options for reducing pain and disability in adults with chronic low back pain: pilates, strength, core-based, and mind-body. A network meta-analysis","volume":"52","author":"Fern\u00e1ndez-Rodr\u00edguez","journal-title":"J Orthop Sports Phys Ther"},{"issue":"2","key":"R47","doi-asserted-by":"publisher","DOI":"10.2196\/10201","article-title":"The effectiveness and safety of utilizing mobile phone-based programs for rehabilitation after lumbar spinal surgery: multicenter, prospective randomized controlled trial","volume":"7","author":"Hou","journal-title":"JMIR Mhealth Uhealth"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2024\/1\/e56580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:45:43Z","timestamp":1782841543000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2024\/1\/e56580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,6]]},"references-count":47,"URL":"https:\/\/doi.org\/10.2196\/56580","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,6]]},"article-number":"v12i10070e56580"}}