Effectiveness of App-based Telerehabilitation For Hemiplegic Shoulder Pain: A Randomized Controlled Trial

Objectives: This study aimed to evaluate the efficacy of a mobile application–based telerehabilitation program as a supplementary intervention to conventional rehabilitation in enhancing range of motion (ROM), pain relief, and functional shoulder capacity among stroke patients with hemiplegic shoulder pain (HSP). Methods: This randomized controlled trial involved ۴۰ stroke patients with HSP (n=۲۰ per group) and was conducted over a ۱۲-week period from November ۲۰۲۴ to July ۲۰۲۵. The participants were divided into an intervention group (conventional rehabilitation plus telerehabilitation) and a control group (conventional rehabilitation only). The outcomes measured were ROM and the shoulder pain and disability index (SPADI). Results: Both the intervention and control groups showed significant within-group improvement (P≤۰.۰۱) across all shoulder ROM and SPADI outcomes, demonstrating large effect sizes (r=۰.۷–۰.۸۸). Details of the within-group improvements (reported as Mean±SD change) are as follows: for flexion ROM (intervention, ۱۱.۶۷±۹.۲; control, ۱۹.۴۴±۱۶.۶), abduction ROM (intervention, ۲۰.۰±۱۵.۹; control, ۲۷.۷۷±۱۹.۸۶), SPADI pain (intervention, ۱۶.۴±۷.۷۵; control, ۱۳.۵±۶.۶۸), and SPADI disability (intervention, ۲۴.۸۹±۸.۰۶; control, ۱۹.۳۹±۶.۱۴). When comparing the two groups, the intervention group showed superior improvement, notably in disability scores (P=۰.۰۳۱), with a mean difference change of ۵.۵ (۹۵% CI, ۰.۶%, ۱۰.۳%) and a medium effect size (r=۰.۳۵). No statistically significant between-group differences were observed in pain (P=۰.۱۳۴), flexion ROM (P=۰.۱۸۱), or abduction ROM (P=۰.۲۰۴). Discussion: The supplementary telerehabilitation program provides a superior improvement, specifically in disability scores for HSP patients, though it does not significantly enhance pain relief or ROM beyond conventional rehabilitation.

کلیدواژه ها:

Hemiplegic shoulder pain (HSP) ، Stroke ، Telerehabilitation