Is online exercise at home more effective than hydrotherapy and physiotherapy in patients with non-specific chronic low back pain? A randomized clinical trial

Abstract Purpose: Many non-pharmaceutical methods have been proposed for the treatment of non-specific chronic low back pain (NCLBP), including Online Exercise at Home (OEH), Hydrotherapy, and Physiotherapy approaches that have shown significant effects. Nevertheless, there are ambiguities in choosing the best option. Therefore, the present study was designed to compare these methods. Methods: This randomized clinical trial included 60 patients with NCLBP (25-45 yrs). After selection, they were randomly divided into three groups (20 patients in each) of OEH (including core stability exercises and education), Hydrotherapy, and Physiotherapy (including hot pack, ultrasound, and TENS), then received interventions for 12 weeks. Visual Analog Scale (VAS) was used to evaluate pain before and after treatment. ANOCOVA and paired t-test were used to analyze the data and a significant level of P <0.05. Results: The results showed that all three treatments used in this study had a significant effect (p <0.05) on reducing the pain intensity for the patients after the intervention. There was no significant difference between the three treatments in reducing pain; however, OEH method could reduce the pain to a greater extent (32.79%). Conclusion: Although the present study reaffirms the effectiveness of all three-treatment approaches, no significant differences were found in the selection of the best option. However, depending on the patient's condition, one of these methods can be selected. Therefore, we introduce hydrotherapy, and Physiotherapy methods for the elderly, severe pain and disability, and OEH as an available method to save money, time and, most importantly, prevent Covid-19 disease.