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Home-Based Telemedicine in Patients with Chronic Neck Pain
Bernardo Gialanella1, Teresa Ettori, Sabrina Faustini
1From the Operative Unit for Recovery and Functional Rehabilitation (BG, TE, SF), Telemedicine Service (DB, PB, SS), and Health Directorate (LC), Salvatore Maugeri Foundation, IRCCS, Institute of Lumezzane, Brescia, Italy.
Objective:
To investigate if a structured physician-directed, nurse-managed, home-based telemedicine (HBT) program, consisting of scheduled/unscheduled phone surveillance, can reduce pain in patients with chronic neck pain.
Design:
This is a prospective randomized controlled study conducted on outpatients. Following outpatient rehabilitation, patients (n = 100) were consecutively randomized to a 6-month HBT program (HBT group) or no HBT but only the recommendation to continue exercising at home (control group). At baseline and after 6 months, pain severity (visual analog scale) and disability (Neck Disability Index) were evaluated.
Results:
At 6 months, neck pain and disability declined in both groups (P < 0.001 for both groups, both parameters), but the decline was significantly more marked in the HBT group (P = 0.001, both parameters). At 6 months, 87.2% of HBT patients and 65.9% of control subjects were performing home exercises (in the range of 2-7 exercise sessions/wk). Pain and disability scores were correlated to participation in the HBT program, patients' perception of HBT, and adherence to home exercises.
Conclusions:
Home-based telemedicine may be a useful additional tool to help physicians in the management of chronic neck pain.
