Physiotherapist-Supervised Online Exercise in Remote White-Collar Workers

The expansion of remote working has increased interest in digital health approaches that can be delivered in the home setting. Among these, physiotherapist-supervised online exercise programs may offer an individualized and accessible intervention model, as they can be delivered through technological devices and tailored to each participant's physical needs.

Remote white-collar workers are often exposed to prolonged sitting, desk-based work, and limited movement during the day. These conditions can contribute to postural impairments and adverse musculoskeletal outcomes, including pain, reduced flexibility, decreased muscle performance, and limitations in daily functioning. Common postural deviations in desk-based workers include forward head posture, rounded shoulders, increased thoracic kyphosis, and reduced lumbar curvature. Such problems may negatively affect both physical comfort and functional performance.

Telerehabilitation-based exercise interventions can improve access to physiotherapy services while allowing participants to engage in structured exercise sessions without leaving their home or work environment. In this context, the present study is designed to evaluate the effects of a physiotherapist-supervised online exercise program on pain intensity and functional performance in remote white-collar workers and to provide preliminary evidence regarding the clinical effectiveness of this intervention model. Participants will undergo a six-week online exercise program supervised by a physiotherapist, consisting of two sessions per week, with each session lasting 40-50 minutes. Pain intensity will be measured using the Visual Analog Scale (VAS), and functional performance will be evaluated using the sit-up test, lateral bridge test, and bilateral squat test.

• Online exercise program (Other): The online exercise intervention in this study will consist of a structured program including a warm-up period, shoulder girdle stabilization exercises, stretching exercises for the upper and lower extremities, back extensor strengthening, lower-extremity balance and coordination training, and a cool-down period. All exercises will be delivered in an online setting under the supervision of a physiotherapist. Each exercise will be performed in two sets of 10 repetitions. The intervention will be implemented over a period of six weeks, with two sessions per week, and each session will last approximately 40 to 50 minutes. After completion of the baseline assessments, participants will begin the exercise program with a warm-up phase intended to increase cardiorespiratory activity and prepare the neuromuscular system for exercise. The warm-up will include marching in place, controlled breathing exercises, and shoulder abduction.

Primary outcomes

• Change in Pain intensity [Baseline and the end of the 6 weeks exercise program]: Pain intensity will be assessed using a 10-cm Visual Analog Scale (VAS). The VAS is a widely used self-reported measure of pain consisting of a horizontal line anchored by "no pain" at one end and "worst imaginable pain" at the other. Participants will be asked to mark the point on the line that best represents their pain intensity, and the score will be recorded in centimeters. Higher scores will indicate greater pain intensity.
• Change in lower-extremity functional strength and endurance [Baseline and the end of the 6 weeks exercise program]: Lower-extremity functional strength and endurance will be assessed using the bilateral squat test. The number of correctly performed repetitions completed in 30 seconds will be recorded.
• Change in core muscle endurance [Baseline and the end of the 6 weeks exercise program]: The lateral bridge test will assess core muscle endurance by recording the duration participants can maintain the side-bridge position. The duration for which the side-bridge position can be maintained will be recorded in seconds.
• Change in abdominal and hip flexor muscle strength and endurance [Baseline and the end of the 6 weeks exercise program]: The sit-up test will assess abdominal and hip flexor muscle strength and endurance by recording the number of correctly completed repetitions during the test period.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* White-collar individuals who have been working remotely for at least 3 months
* Aged 18 years or older
* Having low back pain and/or neck pain related to the remote working process, or reporting a perceived postural disorder
* Having a sedentary lifestyle

Exclusion Criteria:

* History of chronic disease
* Presence of a neurological or psychiatric disorder
* Visual or hearing impairment
* Inability to cooperate with the study procedures