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Comparing Digital to Conventional Physical Therapy for Chronic Shoulder Pain: Randomized Controlled Trial.

Sang S Pak1, Dora Janela2, Nina Freitas1

  • 1Department of Physical Therapy and Rehabilitation, University of California San Francisco, San Francisco, CA, United States.

Journal of Medical Internet Research
|July 25, 2023
PubMed
Summary
This summary is machine-generated.

Digital physical therapy offers a viable, effective alternative for chronic shoulder pain (CSP) management, demonstrating comparable outcomes to in-person care. This approach enhances accessibility and patient adherence without compromising results.

Keywords:
chronic shoulderclinical outcomedigital caredigital health interventionmusculoskeletal painpain managementphysical therapyremote sensing technologytelerehabilitation

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Area of Science:

  • Orthopedics and Sports Medicine
  • Digital Health and Telemedicine
  • Physical Therapy and Rehabilitation

Background:

  • Chronic shoulder pain (CSP) significantly impacts quality of life and productivity, with physical therapy as a primary treatment.
  • Barriers to accessing in-person physical therapy are common, leading to exploration of alternative delivery models like telerehabilitation.
  • Digital physical therapy offers potential benefits including improved access, convenience, adherence, and cost reduction for CSP management.

Purpose of the Study:

  • To compare the clinical outcomes of digital physical therapy versus conventional in-person physical therapy for patients with nonoperative chronic shoulder pain.
  • To evaluate the effectiveness and viability of fully remote digital rehabilitation programs as a care delivery model for CSP.

Main Methods:

  • A single-center, parallel-group randomized controlled trial involving 82 patients with CSP.
  • Participants were randomized to an 8-week digital intervention (home exercise, education, CBT with biofeedback) or conventional in-person physical therapy.
  • Primary outcome: change in function and symptoms (short-form Disabilities of the Arm, Shoulder, and Hand questionnaire); secondary outcomes included pain, surgery intent, and mental health.

Main Results:

  • Both digital and conventional physical therapy groups showed significant improvements in function, with no statistically significant difference between groups.
  • No significant differences were observed in surgery intent, analgesic intake, mental health, or worst pain between the digital and conventional therapy groups.
  • High adherence and satisfaction were reported in both groups, with no adverse events, indicating the safety and acceptability of digital CSP management.

Conclusions:

  • Fully remote digital physical therapy programs are a scalable and effective care delivery model for chronic shoulder pain.
  • Digital interventions provide comparable clinical outcomes to high-dosage in-person rehabilitation, addressing access barriers and improving patient experience.
  • The study supports the integration of digital health solutions into standard care pathways for nonoperative chronic shoulder pain.