Enhancing client-centered care with the ENBORTH-Telerehabilitation program in chronic neck and back pain: A randomized controlled trial

Introduction This study aimed to evaluate the additional effects of the ENBORTH-TR intervention on pain, kinesiophobia, occupational performance, and satisfaction in individuals with neck and/or back pain (NBP). Method A total of 136 participants were included in the study. The participants were divided into two groups: the intervention group (n = 67) and the control group (n = 69). A client-centered (CC) intervention was administered to both groups for 4 weeks (3 sessions per week). During this period, the intervention group also received the ENBORTH-TR intervention, which included basic pain education, ergonomic and environmental adaptations, as well as sleep and psychosocial management. All interventions in the study were delivered via telerehabilitation. Occupational performance (Canadian Occupational Performance Measure) and kinesiophobia (Tampa Kinesiophobia Scale) were defined as primary outcomes. Pain intensity (Visual Analog Scale—assessed during activity, rest, and sleep) was used as a secondary outcome. Results Following the intervention, the intervention group showed statistically significant improvement in all parameters compared to the control group ( p < 0.05). The addition of the ENBORTH-TR intervention had a high effect on the primary outcome of occupational performance and satisfaction (η 2 =0.196−0.303; 95% CI for performance:−1.84 to −0.22; satisfaction: −1.62 to −2.36) and a moderate effect on kinesiophobia scores (η 2 =0.061−0.136; 95% CI: 1.60 to 8.79). Regarding the secondary outcomes, significant reductions were observed in pain intensity, particularly during activity (95% CI: 0.57 to 1.75). Discussion The integration of ENBORTH-TR into standard CC treatment provides significant short-term additional benefits in terms of improving occupational performance and reducing kinesiophobia in patients with NBP.