From hands-on to remote: Moderators of response to a novel self-management telehealth programme during the COVID-19 pandemic

Carlos Gevers-Montoro, Zoha Deldar, Andrea Furlan, Eric Arthur Lazar, Erfan Ghalibaf, Arantxa Ortega de Mues, Ali Khatibi

Research output: Contribution to journalArticlepeer-review

47 Downloads (Pure)


Background: In March 2020, state-wide lockdowns were declared in many countries, including Spain. Citizens were confined to their homes and remotely supported activities were prioritized as an alternative to in-person interactions. Previous data suggest that remote and self-management interventions may be successful at reducing pain and related psychological variables. However, individual factors influencing the effectiveness of these interventions remain to be identified. We aimed to investigate the psychological and motivational factors moderating changes in pain observed in chiropractic patients undertaking a novel telehealth self-management programme. Methods: A cohort of 208 patients from a chiropractic teaching clinic was recruited to participate in the study. Patients received telehealth consultations and individualized self-management strategies tailored for their current complaint. They were encouraged to make use of these strategies daily for 2–4 weeks, whilst rating their pain intensity, motivation and adherence. Validated questionnaires were completed online to assess catastrophizing, kinesiophobia and anxiety. Results: A total of 168 patients completed the first 2 weeks of the programme, experiencing significant reductions in all variables. Kinesiophobia emerged as a key factor influencing pain reduction and moderating the association between motivation and pain relief. In turn, adherence to the programme was associated with lower pain intensity, although moderated by the degree of motivation. Conclusions: In the context of COVID-19, when introducing remote and self-management strategies, pain cognitions and motivational factors should be taken into consideration to foster adherence and yield better pain outcomes.

Original languageEnglish
Pages (from-to)1368-1379
Number of pages12
JournalEuropean Journal of Pain
Issue number6
Publication statusPublished - 24 May 2022

Bibliographical note

Funding Information:
We thank the patients and chiropractic interns for their time and interest in participating in the study. We thank particularly Sara Presazzi, Isabel Turri, Miguel de Castro and Fátima Sánchez de Ibargüen for providing their videos to be used as Muldimedia Appendices. Figure 1 was created with

Publisher Copyright:
© 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.


  • Telehealth
  • Pain self-management
  • Moderation
  • Adherence
  • Fear-avoidance
  • Chiropractic


Dive into the research topics of 'From hands-on to remote: Moderators of response to a novel self-management telehealth programme during the COVID-19 pandemic'. Together they form a unique fingerprint.

Cite this