Feasibility and effectiveness of telerehabilitation in the practice of musculoskeletal physiotherapy for adults with non-specific low back pain

Telerehabilitation treatment: Participant will undergo one familiarisation session about the technology device and apps setting such as Zoom apps or Google Meet with the physiotherapists during face-to-face session after the randomisation. Participants allocated to the telerehabilitation group will schedule their physiotherapy session via Zoom Apps by email or telephone with the telerehabilitation physiotherapist for the following session. Participants will received the telerehabilitation at their own homes. If participants might face internet challenges, necessary adjustments will be made. Alternative communication such as WhatApps or SMS. Additionally, appointment rescheduling is one of the alternative options too. The exercise program was designed during the consultation with physiotherapist. The intervention will be delivered over 8 weeks by a maximum total of eight Zoom session in real time with a physiotherapist. The initial consultation will last up to one hour, while subsequent consultation will be 45- 60 minutes. The physiotherapist and the participant will agree on the number of consultation and treatment sessions according to the client’s progression. During the telerehabilitation session, a home exercise program will be designed according to the client’s individual goals, and the performance of remotely supervised exercises. The initial exercise prescription will have a dosage of ten repetitions each and perform exercises once a day. The exercise dosage and progression dosage will use in this study is based on previous literatures. Recruitment rate will be measure during the recruitment stage of the trial. Other feasibility outcome measures such as adherence rate will be measured by the return of logbooks from the participants. For the attendance rate, the numbers of the attendance rate participants in both groups will be monitor and been record by the physiotherapists in charge in conventional physiotherapy group and telerehabilitation group. The examples of exercises prescribed were MzKenzie approach, core stability exercises, Stretching exercises, cognitive functional therapy, patient education. The examples of MzKenzie approach are extension in standing, flexion in lying, The examples of core stability exercise are lumbar stabilization exercise, four point kneeling with alternative arm and leg extension exercise. The examples of stretching exercises are double knees to chest stretch, piriformis stretch The choice of the exercises was guided by the history, physical examination finding and physiotherapist's impression. The exercise intensity commonly is 10-15 repetitions with 10 seconds hold/ 2-3 sessions per day