Tele-rehabilitation Versus In-clinic Exercise Therapy for Shoulder Tendinopathy: A Randomized Clinical Trial

Objectives: Rotator cuff tendinopathy (RCT), affecting ۱۵-۲۷% of adults, is a leading cause of shoulder disability with significant socioeconomic impacts. While exercise therapy remains the first-line treatment, tele-rehabilitation emerges as a potentially cost-effective alternative to clinic-based care. This study aimed to compare the efficacy of tele-rehabilitation versus in-clinic exercise therapy for pain, disability, function, and quality of life (QoL) in patients with RCT. Methods: This randomized controlled trial compared tele-rehabilitation versus in-clinic exercise therapy in ۴۰ patients with RCT. Both groups received ۱۰ supervised ۴۵-minute sessions over ۴ weeks and performed identical Codman pendulum and strengthening exercises. Visual analog scale (VAS), disabilities of the arm, shoulder, and hand (DASH) questionnaire, and brief World Health Organization QoL (WHOQOL-BREF) scale were assessed at baseline, post-intervention, and ۲-month follow-up using Generalized linear mixed-effects model (LMM) analysis. Results: Both groups demonstrated significant reductions in pain and disability (P<۰.۰۰۱), as well as improvements in the DASH questionnaire and the WHOQOL-BREF scale (P<۰.۰۰۱) post-intervention and at ۲-month follow-up. However, no significant difference was found between the two groups. Although improvement trends were similar between groups (P>۰.۰۵), a significant time-by-group interaction was observed for the DASH questionnaire (P=۰.۰۰۸). Discussion: Both in-clinic exercise and tele-rehabilitation effectively reduce pain and disability from RCT, improving patients’ functional abilities and QoL. Tele-rehabilitation is particularly valuable as a complementary treatment during pandemics or when access to physical therapy is limited, offering convenience, flexibility, and increased patient adherence.

کلیدواژه ها:

Tendinopathy ، Rotator cuff ، Tele-rehabilitation ، Exercise therapy ، Pain