Physical Therapy Exercise Protocol for Chronic Low Back Pain: Synchronous Online Prescription

Chronic low back pain is a leading cause of functional disability, impacting quality of life and limiting daily activities. Aiming to find effective and accessible therapeutic alternatives in contexts with limited in-person care, this pilot study investigated the effects of a 12-week physical therapy protocol on two participants: one treated in person and the other through synchronous online sessions. Assessments included muscle strength, flexibility, pain-related functionality (Roland-Morris), postural control, and static stabilometry (Baropodometry). The online participant had a 75% reduction in functional disability (Roland-Morris from 8 to 2), increased flexibility (30 cm to 42.5 cm in the "Sit and Reach" test), abdominal strength (29 to 46 repetitions), and handgrip strength (26 kg to 51 kg). The in-person participant reduced functional disability by 66.67% (Roland-Morris from 12 to 4), increased flexibility (20.5 cm to 33 cm), abdominal strength (25 to 36 repetitions), and handgrip (22 kg to 47 kg). In stabilometry, the online participant presented changes in the COP position, with a lateral displacement of 0.1 mm to -1.7 mm and anteroposterior displacement of -3.0 mm to -3.4 mm, indicating postural reorganization. The average displacement velocity decreased from 11.1 mm/s to 9.7 mm/s, suggesting greater postural control. The in-person participant had changes in the COP position (X from -3.4 mm to 0.0 mm and Y from - 4.3 mm to -5.3 mm) and a reduction in displacement velocity from 6.7 mm/s to 6.6 mm/s, maintaining stable postural control. These results suggest that the online protocol may be an effective alternative for telerehabilitation of patients with chronic low back pain, promoting significant improvements in function and postural control.