Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care

Spine (Phila Pa 1976). 2013 May 15;38(11):947-52. doi: 10.1097/BRS.0b013e318281a36c.


Study design: A descriptive study of repeated measures using a crossover design.

Objective: To determine the level of agreement between assessments obtained via telerehabilitation and those obtained by traditional face-to-face method in a population of individuals with chronic low back pain (LBP) in a primary care setting.

Summary of background data: Musculoskeletal assessment using telerehabilitation has shown adequate inter- and intrarater agreement and concordance with face-to-face clinical assessment in different diseases. There have been no published studies on the reliability of a telerehabilitation system to assess LBP.

Methods: Fifteen individuals (6 males; mean age, 37 yr) with chronic LBP attended a session for a clinical interview, followed by face-to-face and real-time online telerehabilitation evaluations. There was a 30-minute interval between the 2 assessments, the order of which was randomly selected for each patient. The telerehabilitation system used an Internet application conducted via Internet connection (17 kB/s) between 2 personal computers. Real-time video connection facilitated communication between the therapist and the subject. Outcome measures included lumbar spine mobility, Sorensen test, anterior straight leg raise test, Oswestry Disability Index, visual analogue scale for pain, 12-Item Short Form Health Survey questionnaire, and Tampa Kinesiophobia Scale.

Results: The α reliability between face-to-face and telerehabilitation evaluations was more than 0.80 for 7 of the 9 outcome measures. Lowest reliability was for lateral flexion range of motion (α= 0.75). Very good inter- and intrarater intraclass correlation coefficients (ρ) were obtained (0.92-0.96).

Conclusion: The findings of our pilot study suggest that this telerehabilitation system may be useful to assess individuals with chronic LBP, providing initial support for its implementation in primary care.

Level of evidence: 2.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Over Studies
  • Disability Evaluation
  • Double-Blind Method
  • Female
  • Humans
  • Interviews as Topic / methods*
  • Kinesiology, Applied
  • Low Back Pain / diagnosis*
  • Low Back Pain / physiopathology
  • Male
  • Muscle, Skeletal / physiopathology
  • Outcome Assessment, Health Care / methods
  • Physical Endurance
  • Primary Health Care / methods*
  • Quality of Life
  • Range of Motion, Articular
  • Remote Consultation / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Surveys and Questionnaires