Restricted accessResearch articleFirst published online 2026-3
Effects of basic body awareness therapy via hybrid telerehabilitation on musculoskeletal and psychological symptoms in university students: A single-blind randomized controlled trial
Basic Body Awareness Therapy (BBAT), a mind-body modality, is known for its positive effects on physical and psychological health.
Objective
To assess the role of BBAT via hybrid telerehabilitation on musculoskeletal and psychological symptoms in university students.
Methods
Involving 60 university student volunteers, a single-blind, randomized controlled trial was conducted. The students were categorized into two groups with equal participants: BBAT and Control Group. An Information Workshop was held for both groups. Additionally, the BBAT Group practiced BBAT sessions once a week for 12 weeks, face-to-face during the first 6 weeks and online for the following 6 weeks. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) for musculoskeletal symptoms and Brief Symptom Inventory 53-items (BSI-53) for psychological symptoms were applied at baseline and after 12 weeks.
Results
The BBAT Group demonstrated a significant improvement in Total CMDQ, CMDQ left upper arm and lower back body parts, Total BSI-53, BSI-53 hostility subscale, and Global Severity Index (p = 0.018, r = 0.31; p = 0.011, r = 0.33; p = 0.019, r = 0.30; p = 0.033, r = 0.28; p = 0.036, η2 = 0.074; p = 0.033, r = 0.28, respectively) compared to the Control Group.
Conclusion
BBAT via hybrid telerehabilitation has been found to positively affect musculoskeletal and psychological symptoms, and studies comparing online, face-to-face, and hybrid BBAT in clinical practice are recommended.
SalawuAGreenACrooksMG, et al.A proposal for multidisciplinary tele-rehabilitation in the assessment and rehabilitation of COVID-19 survivors. Int J Environ Res Public Health2020; 17: 4890.
2.
Muñoz-TomásMTBurillo-LafuenteMVicente-ParraA, et al.Telerehabilitation as a therapeutic exercise tool versus face-to-face physiotherapy: a systematic review. Int J Environ Res Public Health2023; 20: 4358.
3.
KocyigitBFAssylbekMIYessirkepovM. Telerehabilitation: lessons from the COVID-19 pandemic and future perspectives. Rheumatol Int2024; 44: 577–582.
4.
ÖzerAYŞenocakEAybeyBN, et al.The effects of the hybrid telerehabilitation exercise program in inactive university students during COVID-19 pandemic – A randomized controlled study. Phys Medizin, Rehabil Kurortmedizin2023; 33: 33–40.
5.
AmroAAlbakrySJaradatM, et al.Musculoskeletal Disorders and Association with Social Media Use Among University Students at the Quarantine Time Of COVID-19 Outbreak. J Phys Med Rehabil Stud2020; 1: 104.
6.
LiuCHZhangEWongGTF, et al.Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: clinical implications for U.S. Young adult mental health. Psychiatry Res2020; 290: 113172.
7.
AslanIOchnikDÇınarO. Exploring perceived stress among students in Turkey during the COVID-19 pandemic. Int J Environ Res Public Health2020; 17: 8961.
8.
KwonCYKwakHYKimJW. Using mind–body modalities via telemedicine during the COVID-19 crisis: cases in the Republic of Korea. Int J Environ Res Public Health2020; 17: 4477.
9.
MehlingWEWrubelJDaubenmierJJ, et al.Body awareness: a phenomenological inquiry into the common ground of mind-body therapies. Philos Ethics, Humanit Med2011; 6: 1–12.
10.
MesserDHoranJJTurnerW, et al.The effects of internet-delivered mindfulness training on stress, coping, and mindfulness in university students. AERA Open2015; 2: 2332858415625188.
11.
YüceHGökmenGYAkçayB, et al.The effect of basic body awareness therapy on awareness, stress and anxiety in pregnant women. Adv Integr Med2024; 11: 280–284.
12.
VancampfortDBrunnerEVan DammeT, et al.Efficacy of basic body awareness therapy on functional outcomes: a systematic review and meta-analysis of randomized controlled trials. Physiother Res Int2023; 28: e1975.
13.
SeferiadisAOhlinPBillhultA, et al.Basic body awareness therapy or exercise therapy for the treatment of chronic whiplash associated disorders: a randomized comparative clinical trial. Disabil Rehabil2016; 38: 442–451.
14.
SkjaervenLHMattssonMCatalan-MatamorosD, et al.Consensus on core phenomena and statements describing basic body awareness therapy within the movement awareness domain in physiotherapy. Physiother Theory Pract2019; 35: 80–93.
15.
OlsenALMagnussenLHSkjaervenLH, et al.Basic Body Awareness Therapy versus standard care in hip osteoarthritis. A randomized controlled trial. Physiother Res Int2022; 27: e1930.
16.
Malmgren-OlssonEBArmeliusBÅArmeliusK. A comparative outcome study of body awareness therapy, feldenkrais, and conventional physiotherapy for patients with nonspecific musculoskeletal disorders: changes in psychological symptoms, pain, and self-image. Physiother Theory Pract2001; 17: 77–95.
HedgeAMorimotoSMccrobieD. Effects of keyboard tray geometry on upper body posture and comfort. Ergonomics1999; 42: 1333–1349.
19.
ErdincOHotKOzkayaM. Turkish version of the cornell musculoskeletal discomfort questionnaire: cross-cultural adaptation and validation. Work2011; 39: 251–260.
20.
ÖzkanNFKahyaE. Bir üniversitenin idari ofislerindeki ergonomik risklerin değerlendirilmesi. Gazi Üniversitesi Mühendislik-Mimarlık Fakültesi Derg2017; 32: 141–150.
21.
KreuzfeldSSeibtRKumarM, et al.German version of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ): translation and validation. J Occup Med Toxicol2016; 11: 13.
22.
SahinNHDurakA. Kisa semptom envanteri (brief symptom invetory-BSI): Turk gencleri icin uyarlanmasi. Türk Psikol Derg1994; 9: 44–56.
23.
YüceHKeçelioğluŞ. Fizyoterapide Zihin-Beden Birlikteliğini Amaçlayan Bütüncül Bir Yaklaşım: temel Beden Farkındalık Terapisi–Literatür Derlemesi. İzmir Katip Çelebi Üniversitesi Sağlık Bilim Fakültesi Derg2022; 7: 157–165.
24.
RichardsonJT. Eta squared and partial eta squared as measures of effect size in educational research. Educ Res Rev2011; 6: 135–147.
25.
PrajapatiSPPurohitA. Prevalence of musculoskeletal disorder among college students in times of COVID-19 pandemic - an observational study. Int J Heal Sci Res2021; 11: 214–218.
26.
RoggioFTrovatoBRavalliS, et al.One year of COVID-19 pandemic in Italy: effect of sedentary behavior on physical activity levels and musculoskeletal pain among university students. Int J Environ Res Public Health2021; 18: 8680.
27.
GüneşSUlusoyBHAygenE, et al.Musculoskeletal system pain and related factors during online education in the COVID-19 pandemic among Ankara university faculty of medicine students, Turkey. J Ankara Univ Fac Med2022; 75: 36–41.
28.
YaseenQBSalahH. The impact of e-learning during COVID-19 pandemic on students’ body aches in palestine. Sci Rep2021; 11: 1–9.
29.
AytarAAltıntaşAAytarA. Effects of posture and ergonomics training for students receiving distance education during the COVID-19 pandemic on musculoskeletal pain, exercise behavior decision-making balance, and physical activity level. J Exerc Ther Rehabil2020; 7: 137–144.
30.
Akulwar-TajaneIDarveshMGhuleM, et al.Effects of COVID −19 pandemic lock down on posture in physiotherapy students: a CrossSectional study. Med Clin Res2021; 6: 91–102.
31.
DaherAHalperinO. Association between psychological stress and neck pain among college students during the coronavirus disease of 2019 pandemic: a questionnaire-based cross-sectional study. Healthc2021; 9: 1526.
32.
GębskaMDalewskiBPałkaŁ, et al.The importance of type d personality in the development of temporomandibular disorders (TMDs) and depression in students during the COVID-19 pandemic. Brain Sci2021; 12: 28.
GyllenstenALSkoglundKWulfI. Basic Body Awareness Therapy: Embodied identity. Stockholm: Vulkan, 2018.
35.
GyllenstenAL. Basic body awareness therapy. Assessment, treatment and interaction. Doctoral Thesis, Lund University, Sweden2001.
36.
CramerHMehlingWESahaFJ, et al.Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain. BMC Musculoskelet Disord2018; 19: 1–10.
37.
ÖztürkNÖterEGAbacıgilF, et al.Effect of an online posture exercise program during the COVID-19 pandemic on students’ musculoskeletal pain and quality of life. J Back Musculoskelet Rehabil2024; 37: 781–791.
38.
Molina-GarciaPMora-TraversoMPrieto-MorenoR, et al.Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: a systematic review and meta-analysis. Ann Phys Rehabil Med2024; 67: 101791.
39.
JiangCde YoungsterSHawkinsV, et al.Artists’ satisfaction with telerehabilitation in physiotherapy during the COVID-19 pandemic: a cross-sectional study. Physiother Res Int2024; 29: e70002.
40.
SantiagoMCardoso-TeixeiraPPereiraS, et al.A hybrid-telerehabilitation versus a conventional program for urinary incontinence: a randomized trial during COVID-19 pandemic. Int Urogynecol J2023; 34: 717–727.
41.
SatarSŞahinMEKaramanlıH, et al.Tele-pulmonary rehabilitation with face to face in COVID-19 pandemic: a hybrid modeling. Tuberk Toraks2023; 71: 58–66.
42.
KilicBBYildiz OzerAOzarpaciC, et al.The comparison of individual and group hybrid telerehabilitation methods in women with urinary incontinence. Int Urogynecol J2024; 35: 1299–1315.
43.
WuytsMCoosemansIEveraertsS, et al.Hybrid compared to conventional pulmonary rehabilitation: an equivalence analysis. ERJ Open Res2024; 10: 00984–02023.
44.
KrzyzaniakNCardonaMPeirisR, et al.Telerehabilitation versus face-to-face rehabilitation in the management of musculoskeletal conditions: a systematic review and meta-analysis. Phys Ther Rev2023; 28: 71–87.
45.
BurgessDJCalvertCCampbellEMH, et al.Telehealth mindfulness-based interventions for chronic pain: the LAMP randomized clinical trial. JAMA Intern Med2024; 184: 1163–1173.
46.
DayMACiolMAMendozaME, et al.The effects of telehealth-delivered mindfulness meditation, cognitive therapy, and behavioral activation for chronic low back pain: a randomized clinical trial. BMC Med2024; 22: 156.
47.
TahranÖErsoz HuseyinsinogluBYolcuG, et al.Comparing face-to-face and internet-based basic body awareness therapy for fibromyalgia: a randomized controlled trial. Disabil Rehabil2025: 1–12.
48.
TantawySARahmanAAAmeerMA. The relationship between the development of musculoskeletal disorders, body mass index, and academic stress in Bahraini university students. Korean J Pain2017; 30: 126–133.
49.
GyllenstenALSkärLMillerM, et al.Embodied identity - A deeper understanding of body awareness. Physiother Theory Pract2010; 26: 439–446.
50.
GyllenstenALJacobsenLNGardG. Clinician perspectives of basic body awareness therapy (BBAT) in mental health physical therapy: an international qualitative study. J Bodyw Mov Ther2019; 23: 746–751.
51.
AdawiMZerbettoRReTS, et al.Psychometric properties of the brief symptom inventory in nomophobic subjects: insights from preliminary confirmatory factor, exploratory factor, and clustering analyses in a sample of healthy Italian volunteers. Psychol Res Behav Manag2019; 12: 145.
52.
ErikssonEMMöllerIESöderbergRH, et al.Body awareness therapy: a new strategy for relief of symptoms in irritable bowel syndrome patients. World J Gastroenterol2007; 13: 3206–3214.
53.
ErikssonEMAndrénKIKurlbergGK, et al.Aspects of the non-pharmacological treatment of irritable bowel syndrome. World J Gastroenterol2015; 21: 11439–11449.
54.
GyllenstenALHanssonLEkdahlC. Outcome of basic body awareness therapy. A randomized controlled study of patients in psychiatric outpatient care. Adv Physiother2003; 5: 179–190.
55.
GyllenstenALEkdahlCHanssonL. Long-term effectiveness of basic body awareness therapy in psychiatric outpatient care. A randomized controlled study. Adv Physiother2009; 11: 2–12.
56.
Catalan-MatamorosDHelvik-SkjaervenLLabajos-ManzanaresMT, et al.A pilot study on the effect of basic body awareness therapy in patients with eating disorders: a randomized controlled trial. Clin Rehabil2011; 25: 617–626.
57.
JönssonTEkvall HanssonEThorstenssonCA, et al.The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy - an intervention study with a reference group. BMC Musculoskelet Disord2018; 19: 198.
58.
KingSJWesselJBhambhaniY, et al.The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol2002; 29: 2620–2627.
59.
GowansSEDeHueckAVossS, et al.A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Rheum1999; 12: 120–128.
