A Systematic Review on Health Economic Evaluations of Telerehabilitation for Chronic Spinal Pain.

Background: Telerehabilitation can improve clinical outcomes by increasing access to and adherence to rehabilitation protocols, leading to favourable benefits in overall quality of life at a reasonable cost. This systematic review aims to conduct a thorough analysis of published health economic evaluations of standalone telerehabilitation interventions for individuals with chronic spinal pain, focusing on reported costs and clinical outcomes. Methods: An extensive search was conducted in English across four general medical databases and three health economic databases. The studies' quality was evaluated using the updated Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results: Five economic evaluations were identified, comprising three high-quality and two medium-quality studies. Among these studies, four indicated that telerehabilitation interventions were more cost-effective than standard treatment and conventional physical therapy from a social and healthcare perspective. The sixth study, which lacked a comparison group, also demonstrated that the use of remote follow-ups and programming for Spinal Cord Stimulation (SCS) devices in chronic spinal pain is cost-effective. Conclusion: Telerehabilitation, particularly telerehabilitation-based McKenzie therapy (TBMT), may represent the most economically efficient approach compared to conventional treatment interventions for individuals with chronic lumbar spine pain. For a more robust conclusion, it is imperative to conduct comprehensive economic evaluations using larger sample sizes over extended periods across multiple countries.