Subacromial Pain Syndrome
Conditions
Keywords
ChatGPT, DeepSeek, Large Language Models, Shoulder Rehabilitation, Subacromial Pain, Artificial Intelligence
Brief summary
This study aims to evaluate the effects of rehabilitation programs supported by artificial intelligence-based large language models (LLMs), specifically ChatGPT and DeepSeek, in individuals with subacromial pain syndrome (SAPS). Participants will be randomly assigned to one of three groups: standard physiotherapy, standard physiotherapy plus ChatGPT-guided exercises, and standard physiotherapy plus DeepSeek-guided exercises. Outcomes including pain, disability, quality of life, muscle strength, and joint range of motion will be assessed before and after a 6-week intervention. The results will help determine whether AI-generated exercise recommendations can enhance clinical outcomes when combined with conventional physiotherapy.
Detailed description
This completed randomized controlled trial investigated the clinical effects of integrating AI-generated exercise recommendations into conventional physiotherapy for individuals with subacromial pain syndrome (SAPS). A total of 82 individuals were assessed for eligibility; 7 were excluded for not meeting inclusion criteria. Seventy-five participants provided consent and were randomized in a 1:1:1 ratio to 3 groups (n=25 each): (1) conventional physiotherapy plus a conventional exercise program, (2) conventional physiotherapy plus ChatGPT-guided exercises, and (3) conventional physiotherapy plus DeepSeek-guided exercises. The allocation sequence was generated using simple computer-based randomization by an independent staff member and was revealed after completion of baseline assessments. Interventions were delivered over 6 weeks (3 supervised sessions/week). Six participants discontinued the intervention due to scheduling conflicts (2 per group). Sixty-nine participants completed the 6-week intervention and were included in the final analysis (n=23 per group). The primary outcome was shoulder pain and disability (Shoulder Pain and Disability Index, SPADI), assessed at baseline and 6 weeks. Secondary outcomes included pain intensity (Numeric Pain Rating Scale, NPRS), health-related quality of life (Short Form-12, SF-12), upper limb function (Disabilities of the Arm, Shoulder and Hand, Quick DASH), range of motion, isometric strength, kinesiophobia, catastrophizing, emotional status, and disease-specific quality of life.
Interventions
BEHAVIORALConventional Exercise Program
Exercise protocol targeting subacromial pain syndrome, including shoulder mobility, strengthening, and posture correction exercises based on established clinical guidelines.
BEHAVIORALChatGPT-Guided Rehabilitation
AI-generated exercise recommendations from ChatGPT-4 tailored to the patient's profile and applied under physiotherapist supervision.
BEHAVIORALDeepSeek-Guided Rehabilitation
Personalized rehabilitation exercises generated by DeepSeek-R1 and implemented under physiotherapist guidance.
Sponsors
Kirsehir Ahi Evran Universitesi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Masking description
Participants were informed that they would receive one of several supervised exercise-based rehabilitation programmes for subacromial pain syndrome, but were not informed of their specific group assignment or the use of large language models. The physician establishing the diagnosis and the physiotherapist performing all outcome assessments are blinded to group allocation. Treating physiotherapists are aware of group assignment but are not involved in outcome assessments or data analysis.
Intervention model description
Participants will be randomly assigned to three parallel groups: 1. standard physiotherapy combined with a conventional exercise program for subacromial pain syndrome based on current clinical guidelines, 2. standard physiotherapy combined with ChatGPT-guided exercises, and 3. standard physiotherapy combined with DeepSeek-guided exercises.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Being between the ages of 18 and 65 * Having been diagnosed with Subacromial Pain Syndrome (SAPS) for at least four weeks, diagnosed through clinical and physical examination * Actively maintaining shoulder range of motion * Being cognitively and physically capable of participating in an exercise program * Agreeing to participate voluntarily in the research process and providing written consent
Exclusion criteria
* Presence of other shoulder pathologies such as rotator cuff tear, frozen shoulder, glenohumeral instability, or labrum tear * Presence of conditions included in the differential diagnosis such as cervical radiculopathy, neurological disorders, rheumatological diseases, or fibromyalgia * History of shoulder surgery within the last 6 months * Pregnancy * History of systemic or neuromuscular disease * Refusal to consent to voluntary participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Disability (Shoulder Pain and Disability Index, SPADI) | Baseline and after 6 weeks of intervention | Disability related to shoulder pain will be measured.Shoulder Pain and Disability Index (0-100; higher scores indicate worse disability). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in upper extremity function (Quick DASH) | Baseline and after 6 weeks | Functional status of the arm, shoulder, and hand will be assessed using the Disabilities of the Arm, Shoulder and Hand (Quick DASH) questionnaire. Higher scores indicate greater disability. |
| Change in shoulder range of motion (ROM) | Baseline and after 6 weeks | Active range of motion in shoulder flexion, extension, abduction, internal and external rotation will be measured using a standard manual goniometer. |
| Change in Quality of Life (Short Form-12, SF-12) | Baseline and after 6 weeks of intervention | Health-related quality of life will be evaluated.Short Form-12 (Physical Component 12-48; Mental Component 12-48; higher scores indicate better quality of life). |
| Change in Pain Intensity (Numeric Pain Rating Scale, NPRS) | Baseline and after 6 weeks of intervention | Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS) at rest, during activity, and at night. Numeric Pain Rating Scale (0-10; higher scores indicate worse pain). |
| Change in shoulder and elbow muscle strength (K-Force) | Baseline and after 6 weeks | Isometric muscle strength of shoulder and elbow flexion, extension, and rotation will be assessed using the Kinvent K-Force digital dynamometer. Values will be recorded in Newtons. |
| Change in Kinesiophobia (Tampa Scale for Kinesiophobia, TSK) | Baseline and after 6 weeks | Kinesiophobia will be measured using the Tampa Scale for Kinesiophobia (TSK). Tampa Scale for Kinesiophobia (17-68; higher scores indicate greater fear of movement). |
| Change in shoulder function (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, ASES) | Baseline and after 6 weeks | Shoulder function will be evaluated using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES). ASES (0-100; higher scores indicate better shoulder function). |
| Change in Pain Catastrophizing (Pain Catastrophizing Scale, PCS) | Baseline and after 6 weeks of intervention | Pain catastrophizing will be assessed.Pain Catastrophizing Scale (0-52; higher scores indicate worse catastrophizing). |
| Change in disease-specific quality of life (Western Ontario Rotator Cuff Index, WORC) | Baseline and after 6 weeks of intervention | Disease-specific quality of life in patients with shoulder pathology will be measured.WORC (0-2100; higher scores indicate worse symptoms / lower quality of life). |
| Change in Emotional Status (Hospital Anxiety and Depression Scale, HADS) | Baseline and after 6 weeks of intervention | Anxiety and depression will be evaluated.Hospital Anxiety and Depression Scale (0-21 for Anxiety subscale, 0-21 for Depression subscale; higher scores indicate worse symptoms). |
Countries
Turkey (Türkiye)
Outcome results
None listed