Effects of Combined Supervised and Telerehabilitation Exercise Programs on Pain and Disability in Dentists with Chronic Neck Pain: A Randomized Controlled Trial

Abstract

Background: This study was conducted to determine the effects of combined exercises applied with supervised and telerehabilitation methods on pain intensity, pain pressure threshold, muscular endurance, grip strength, neck and upper extremity disabilities in dentists with chronic neck pain (CNP). Methods: Fifty-five dentists with CNP were included in the study and randomly divided into three groups as supervised group (n = 19), telerehabilitation group (n = 19) and control group (n = 17). The participants had a mean age of 35.20 +/- 4.16 years, with ages ranging from 30 to 44 years and of the participants, 43 were female (78%) and 12 were male (22%). Combined exercises consisting of resistance, stretching and postural alignment exercises were applied with supervised and telerehabilitation methods three days a week for 12 weeks. The control group received a non-resistance exercise sheet matching the other protocols. Initially, all patients were assessed for pain intensity (VAS), pain pressure threshold, grip strength (hand, lateral and pinch grip), muscular endurance (deep neck flexors, scapular, static and dynamic core), neck and upper extremity disability. The assessments were repeated after 12 weeks of training. Results: The telerehabilitation group demonstrated positive changes in pain intensity, pain pressure threshold, and neck disability that were statistically significant (p < 0.05). Supervised group has improved all assessments except dynamic core endurance and grip strength (p < 0.05). There was also a decrease in pain intensity and neck disability index in the control group (p < 0.05). When the changes resulting from exercise training were compared between the groups, it was seen that the changes in the supervised group were superior (p < 0.05). Conclusions: The results showed that combined exercises applied under supervision were more effective than telerehabilitation or home exercises in dentists with CNP, and telerehabilitation was more effective than home program. Although the telerehabilitation method is not as effective as supervised exercise training, it can be an alternative method to reduce pain and disability for dentists who cannot participate in a regular exercise program due to their working conditions. Long-term follow-up studies are needed to determine how long the effect of exercise training applied with telerehabilitation continues in dentists with CNP.