Neck pain is the third musculoskeletal condition that causes the most days lived with disability and is considered an important public health problem with a significant economic impact, decreased productivity and work absenteeism. In addition to pain, these individuals also present psychosocial symptoms such as kinesiophobia, catastrophizing, anxiety, and depression. Although exercise is an effective approach in the treatment of chronic neck pain, physiotherapists face barriers to the success of therapy, such as lack of patient adherence. Additionally, due to costs, distance and lack of adequate information, patients do not have access to physiotherapy treatment. Therefore, telerehabilitation is an emerging tool to overcome these barriers. However, despite the literature supporting the effectiveness of telerehabilitation in chronic musculoskeletal conditions, there are no studies on its efficacy in neck pain regarding pain, disability and psychosocial symptoms when compared to face-to-face treatment.

To investigate the efficacy of a telerehabilitation exercise program compared to face-to-face exercise program in patients with chronic neck pain.

The study is a single-blinded randomized controlled trial. Ninety-eight individuals of both sexes, between 18-65 years old, with non-specific neck pain lasting longer than 3 months will be recruited. They will be randomly allocated to one of two groups (telerehabilitation and face-to-face). The telerehabilitation group will perform the intervention at home through videos sent beforehand and weekly call will be made to follow-up the participants. The face-to-face group will perform the intervention with the therapist. The primary outcomes will be pain intensity and disability. Secondary outcomes will be kinesiophobia, catastrophizing, fear avoidance beliefs, symptoms of anxiety and depression, pain self-efficacy and global perceived effect. All participants will be evaluated before and after treatment. Both groups will perform the same exercise protocol, twice a week for six weeks. The protocol consists of 8 exercises (two stretching exercises, two mobility exercises and four strengthening exercises) with an approximate duration of 40 minutes and these will be progressed every two weeks. The statistical analysis will follow the principles of intention-to-treat analysis and the effects of treatment will be calculated using mixed linear models, using interactions terms (group versus time interactions).

This is the first study to investigate whether an exercise program applied via telerehabilitation is effective in reducing pain, disability, and psychosocial symptoms in individuals with chronic neck pain when compared to the same exercise program applied face-to-face.

The results of this study may contribute to a better understanding of the efficacy of telerehabilitation in biopsychosocial outcomes, as well as support future remote intervention research to reduce physical, temporal, financial and treatment adherence barriers that professionals face. In addition, remote treatment may also be able to reduce waiting lists and public spending on chronic neck pain.