Telerehabilitation before and after lumbar spine surgery: A scoping review

Although telerehabilitation has demonstrated effectiveness comparable to traditional face-to-face rehabilitation for low back pain and joint replacement, the lack of standardized protocols after lumbar spine surgery hinders optimal recovery. We mapped existing evidence on telerehabilitation interventions for patients undergoing lumbar spine surgery, focusing on intervention characteristics, identifying evidence gaps, and providing insights for clinical implementation. We searched PubMed, Web of Science, and Physiotherapy Evidence Database for studies published between January 2000 and April 2025. This was a scoping review following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Adults (≥18 years) who underwent lumbar spine surgery and received telerehabilitation interventions were included. The outcome measures were as follows: pain outcomes, functional outcomes, patient engagement in rehabilitation, self-efficacy, and adherence rates. Thirteen reports from eight unique primary studies, encompassing 724 participants (mean age: 40-65 years, 56.6% female) were included. Considerable heterogeneity in intervention timing (preoperatively to 3 months postoperatively), content (exercise therapy, education, counseling, and monitoring), and technology platforms (telephone, smartphone apps, wearable devices, and web platforms) was observed. Six of the eight primary studies reported short-term improvements in pain and functional outcomes; however, reports on long-term effectiveness (>1 year) were inconsistent. Patient engagement in rehabilitation, self-efficacy, and adherence were critical success factors. Telerehabilitation shows promise for supporting patients undergoing lumbar spine surgery, particularly for short-term functional improvements. Future studies should focus on the validation of long-term effectiveness and optimal intervention methods, with patient stratification required to identify the approaches that work best for different patient profiles.