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Digital therapy is as effective as in-person physical therapy for the management of chronic shoulder pain.
A single-center, parallel-group, randomized controlled trial depicted that remote digital programs can serve as effective models for providing care to chronic shoulder pain-affected patients due to their scalability and effectiveness, as evaluated when compared to intensive in-person rehabilitation.
The investigators sought to contrast the clinical outcomes of digital physical therapy with conventional, in-person physical therapy for shoulder pain.
In total, 82 individuals battling chronic shoulder pain who were referred for outpatient physical therapy were enrolled in the study. These participants were randomly assigned to either receive digital or conventional in-person physical therapy, with both interventions spanning over 8 weeks. The digital therapy group engaged in home exercises, educational materials, and cognitive-behavioral therapy (CBT) through a device equipped with movement digitalization for biofeedback.
Additionally, they received asynchronous monitoring by a physical therapist via a cloud-based portal. On the other hand, the conventional therapy group was given in-person physical therapy, which included CBT, education, manual therapy, and exercises. The major endpoint was the alteration in function and symptom severity, assessed utilizing the short-form of Disabilities of the Arm, Shoulder, and Hand questionnaire, from the baseline to the 8-week mark.
Secondary endpoint measures encompassed self-reported pain levels, consideration of surgery, analgesic medication usage, mental well-being, participant engagement, and satisfaction. All of these assessments were administered electronically. As found, 90 volunteers were randomized into either digital or conventional physical therapy groups, but ultimately, 82 individuals received their respective assigned interventions.
Both groups displayed substantial enhancements in their functional abilities, as measured by the short-form Disabilities of the Arm, Shoulder, and Hand questionnaire, with no discernible differences between the two groups, as evidenced by a mean change of -1.8 points. Regarding secondary outcome measures, there were no notable disparities between the groups in terms of their intent for surgery, consumption of analgesic medications, mental health status, or the severity of their worst pain.
Although the conventional therapy group displayed greater reductions in average and least pain, these differences were of small effect sizes (least pain 0.15 and average pain 0.16), making them unlikely to hold clinical significance. Importantly, both groups exhibited high levels of adherence and satisfaction, and there were no reports of adverse events. Therefore, completely remote digital programs have the potential to serve as promising models for delivering care to chronic shoulder pain-affected patients.
Journal of Medical Internet Research
Comparing digital to conventional physical therapy for chronic shoulder pain: A randomized controlled trial
Pak SS et al.
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