"Effectiveness of a Telerehabilitation Program Versus a Conventional Rehabilitation Program in Patients With Subacromial Pain"

NCT07536009 | Not Yet Recruiting DMC

• 2 other identifiers: R-2026-3201-029FMED-001446
• Study Type: interventional
• Target: 82
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purpose of this prospective, randomized, parallel-group, single-center, controlled non-inferiority clinical trial is to determine whether a telerehabilitation program is non-inferior to a conventional rehabilitation program in patients with subacromial pain. Subacromial pain is a prevalent musculoskeletal condition, and while therapeutic exercise is the cornerstone of conservative management, adherence to home programs is often low. Conversely, conventional in-person physical therapy presents logistical and economic barriers for patients. This study aims to evaluate if a well-designed telerehabilitation program, utilizing information and communication technologies for remote monitoring, can provide an effective, accessible, and non-inferior alternative to conventional care. The primary outcome measured will be the change in shoulder function utilizing the QuickDASH questionnaire at 12 weeks. Secondary outcomes will assess pain intensity (VAS), range of motion (ROM), treatment adherence, and long-term functional outcomes.

Conditions

Subacromial Impingement Syndrome

Keywords

Telerehabilitation; Shoulder Pain; Subacromial Impingement Syndrome; Exercise Therapy; Physical Therapy Modalities

Outcome Measures

Primary Outcomes (1)

• Change in Shoulder Function

  Measured by the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). The QuickDASH is an 11-item self-report questionnaire that measures physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb. Scores range from 0 to 100, where 0 indicates no disability (best outcome) and 100 indicates the most severe disability (worst outcome).

  Baseline, 12 and 24 weeks

Secondary Outcomes (5)

• Change in Pain Intensity

  Baseline, 12 and 24 weeks

• Change in Range of Motion (ROM)

  Baseline, 12 and 24 weeks

• Treatment Adherence

  Baseline, 12 and 24 weeks

• Patient Satisfaction

  Baseline, 12 and 24 weeks

• Long-Term Shoulder Function

  24 weeks postintervention

Study Arms (2)

Telerehabilitation

EXPERIMENTAL

A 12- to 24-week digital intervention program including a structured exercise protocol, health education, and cognitive-behavioral therapy (CBT) delivered via the Moodle platform. Exercises focus on mobility, stretching, and gradual strengthening of the shoulder/scapular muscles, recommended 3-4 sessions per week (30 minutes daily).

Other: Digital Physical Therapy (Telerehabilitation)

Conventional Rehabilitation

ACTIVE COMPARATOR

High-dose, in-person physical therapy at the clinic. The program includes therapeutic exercises with graded exposure to movement, manual therapy, and verbal education. Recommended 2-3 in-person sessions per week (30 minutes per session), complemented by home exercises.

Other: Conventional Physical Therapy

Interventions

Digital Physical Therapy (Telerehabilitation) OTHER

Multimodal digital intervention delivered via the Moodle platform. It includes a structured therapeutic exercise program (mobility, stretching, and progressive strengthening of rotator cuff and periscapular muscles), asynchronous remote monitoring by a physical therapist, and digital health education. Cognitive-behavioral therapy (CBT) components focused on pain reconceptualization and coping strategies are also integrated. Patients perform 30-minute daily sessions, 3-4 times per week, for a duration of 12 to 24 weeks.

Telerehabilitation

Conventional Physical Therapy OTHER

Standard in-person rehabilitation program conducted at the clinic. The intervention consists of supervised therapeutic exercises (similar to the experimental group), manual therapy techniques (joint mobilization and soft tissue manipulation as clinically indicated), and verbal health education provided by the physical therapist. Patients attend 2-3 in-person sessions per week, each lasting 30 minutes, for 12 to 24 weeks, complemented by printed home exercise instructions.

Conventional Rehabilitation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Men and women aged 18 years or older.
• Diagnosis of Subacromial Impingement Syndrome (SIS) based on clinical criteria (pain with overhead activities, painful arc, positive Neer, Hawkins, or Jobe test). Radiological confirmation (ultrasound and/or magnetic resonance imaging) is accepted.
• Access to the internet and a device (smartphone, tablet, or computer) capable of running the telerehabilitation platform.
• Willingness and ability to provide written informed consent.

You may not qualify if:

• Shoulder pain caused by fractures, tumors, infections, or severe systemic pathologies.
• Previous surgery on the affected shoulder within the last 3 months.
• Prior joint injection (corticosteroid infiltration) in the affected shoulder within the last 3 months.
• Subjects with partial or full-thickness rotator cuff tears.
• Patients currently receiving concurrent physical therapy (PT) or any other external interventions for the shoulder condition.
• Current participation in another rehabilitation or exercise program.
• Pregnancy.
• Cognitive impairment, communication barriers, or any condition that prevents the patient from following the remote instructions.

Sponsors & Collaborators

• Instituto Mexicano del Seguro Social: lead

Related Publications (16)

• Petersson AH, Bjornsson Hallgren HC, Adolfsson LE, Holmgren TM. No need for subacromial decompression in responders to specific exercise treatment: a 10-year follow-up of a randomized controlled trial. J Shoulder Elbow Surg. 2025 Jun;34(6):e477-e487. doi: 10.1016/j.jse.2024.10.027. Epub 2024 Dec 21.

  PMID: 39716615 BACKGROUND

• Sheth U, Nam D, Richards R, Palinkas V, Wainwright A, Dunn PC, Razmjou H. Agreement on clinical examination and management between virtual videoconferencing and in-person assessment in a tertiary shoulder center. JSES Int. 2025 Jan 28;9(3):859-863. doi: 10.1016/j.jseint.2024.12.021. eCollection 2025 May.

  PMID: 40486802 BACKGROUND

• Martinez-Rico S, Lizaur-Utrilla A, Sebastia-Forcada E, Vizcaya-Moreno MF, de Juan-Herrero J. The Impact of a Phone Assistance Nursing Program on Adherence to Home Exercises and Final Outcomes in Patients Who Underwent Shoulder Instability Surgery: A Randomized Controlled Study. Orthop Nurs. 2018 Nov/Dec;37(6):372-378. doi: 10.1097/NOR.0000000000000501.

  PMID: 30451774 BACKGROUND

• Kane LT, Thakar O, Jamgochian G, Lazarus MD, Abboud JA, Namdari S, Horneff JG. The role of telehealth as a platform for postoperative visits following rotator cuff repair: a prospective, randomized controlled trial. J Shoulder Elbow Surg. 2020 Apr;29(4):775-783. doi: 10.1016/j.jse.2019.12.004.

  PMID: 32197766 BACKGROUND

• Sabbagh R, Shah N, Jenkins S, Macdonald J, Foote A, Matar R, Steffensmeier A, Grawe B. The COVID-19 pandemic and follow-up for shoulder surgery: The impact of a shift toward telemedicine on validated patient-reported outcomes. J Telemed Telecare. 2023 Jul;29(6):484-491. doi: 10.1177/1357633X21990997. Epub 2021 Feb 1.

  PMID: 33525951 BACKGROUND

• Huang T, Zhang W, Yan B, Liu H, Girard O. Comparing Telerehabilitation and Home-based Exercise for Shoulder Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2024 Nov;105(11):2214-2223. doi: 10.1016/j.apmr.2024.02.723. Epub 2024 Mar 2.

  PMID: 38432330 BACKGROUND

• Zhang B, Fang Z, Nian K, Sun B, Ji B. The effects of telemedicine on Rotator cuff-related shoulder function and pain symptoms: a meta-analysis of randomized clinical trials. J Orthop Surg Res. 2024 Aug 14;19(1):478. doi: 10.1186/s13018-024-04986-4.

  PMID: 39143625 BACKGROUND

• Pak SS, Janela D, Freitas N, Costa F, Moulder R, Molinos M, Areias AC, Bento V, Cohen SP, Yanamadala V, Souza RB, Correia FD. Comparing Digital to Conventional Physical Therapy for Chronic Shoulder Pain: Randomized Controlled Trial. J Med Internet Res. 2023 Aug 18;25:e49236. doi: 10.2196/49236.

  PMID: 37490337 BACKGROUND

• Gutierrez-Espinoza H, Araya-Quintanilla F, Cereceda-Muriel C, Alvarez-Bueno C, Martinez-Vizcaino V, Cavero-Redondo I. Effect of supervised physiotherapy versus home exercise program in patients with subacromial impingement syndrome: A systematic review and meta-analysis. Phys Ther Sport. 2020 Jan;41:34-42. doi: 10.1016/j.ptsp.2019.11.003. Epub 2019 Nov 6.

  PMID: 31726386 BACKGROUND

• Gava V, Ribeiro LP, Barreto RPG, Camargo PR. Effectiveness of physical therapy given by telerehabilitation on pain and disability of individuals with shoulder pain: A systematic review. Clin Rehabil. 2022 Jun;36(6):715-725. doi: 10.1177/02692155221083496. Epub 2022 Mar 1.

  PMID: 35230167 BACKGROUND

• Correia FD, Molinos M, Luis S, Carvalho D, Carvalho C, Costa P, Seabra R, Francisco G, Bento V, Lains J. Digitally Assisted Versus Conventional Home-Based Rehabilitation After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2022 Mar 1;101(3):237-249. doi: 10.1097/PHM.0000000000001780.

  PMID: 33935152 BACKGROUND

• Kromer TO, Kohl M, Bastiaenen CHG. Factors predicting long-term outcomes following physiotherapy in patients with subacromial pain syndrome: a secondary analysis. BMC Musculoskelet Disord. 2024 Jul 24;25(1):579. doi: 10.1186/s12891-024-07686-6.

  PMID: 39048996 BACKGROUND

• Lafrance S, Charron M, Dube MO, Desmeules F, Roy JS, Juul-Kristensen B, Kennedy L, McCreesh K. The Efficacy of Exercise Therapy for Rotator Cuff-Related Shoulder Pain According to the FITT Principle: A Systematic Review With Meta-analyses. J Orthop Sports Phys Ther. 2024 Aug;54(8):499-512. doi: 10.2519/jospt.2024.12453.

  PMID: 38848304 BACKGROUND

• Paavola M, Kanto K, Ranstam J, Malmivaara A, Inkinen J, Kalske J, Savolainen V, Sinisaari I, Taimela S, Jarvinen TL; Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators. Subacromial decompression versus diagnostic arthroscopy for shoulder impingement: a 5-year follow-up of a randomised, placebo surgery controlled clinical trial. Br J Sports Med. 2021 Jan;55(2):99-107. doi: 10.1136/bjsports-2020-102216. Epub 2020 Oct 5.

  PMID: 33020137 BACKGROUND

• Back M, Paavola M, Aronen P, Jarvinen TLN, Taimela S; Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators. Return to work after subacromial decompression, diagnostic arthroscopy, or exercise therapy for shoulder impingement: a randomised, placebo-surgery controlled FIMPACT clinical trial with five-year follow-up. BMC Musculoskelet Disord. 2021 Oct 19;22(1):889. doi: 10.1186/s12891-021-04768-7.

  PMID: 34666734 BACKGROUND

• Aguilar Garcia M, Gonzalez Munoz A, Perez Montilla JJ, Aguilar Nunez D, Hamed Hamed D, Pruimboom L, Navarro Ledesma S. Which Multimodal Physiotherapy Treatment Is the Most Effective in People with Shoulder Pain? A Systematic Review and Meta-Analyses. Healthcare (Basel). 2024 Jun 20;12(12):1234. doi: 10.3390/healthcare12121234.

  PMID: 38921347 BACKGROUND

MeSH Terms

Conditions

Shoulder Impingement Syndrome; Shoulder Pain

Interventions

Telerehabilitation

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries; Arthralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services; Telemedicine; Delivery of Health Care; Patient Care Management; Health Services Administration

Central Study Contacts

Roberto Carlos Pech Argüelles, MD

CONTACT

9991520786; drrobertopech@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: April 9, 2026
• First Posted: April 17, 2026
• Study Start: April 15, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): May 30, 2027
• Last Updated: April 21, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL