Effects of augmented reality-based telerehabilitation in adhesive capsulitis of the shoulder: a randomized controlled trial

Background: Home exercise is important for the treatment of adhesive capsulitis of the shoulder (ACS). Although studies on telerehabilitation to increase compliance and accuracy of home exercise are increasing in various musculoskeletal conditions, there are few studies on ACS. Objectives: This study aims to investigate the effectiveness of augmented reality (AR)-based asynchronous telerehabilitation using UNICARE Home+ versus conventional home exercise in participants with ACS. Methods: One hundred participants with unilateral ACS were recruited and randomly assigned to telerehabilitation group (TR group) and conventional rehabilitation group (CR group). All participants, regardless of group, received the same hospital-based physical therapy once or twice for at least 3 months, plus an additional 3 months of home exercise. The TR group performed home exercises with an asynchronous telerehabilitation system, and the CR group performed home exercises with brochures. The primary outcome was the changes in the passive range of motion (PROM) of the affected shoulder joint between baseline and 3 months. The secondary outcomes were active ROM (AROM), shoulder pain measured by Numeric Rating Scale (NRS), shoulder pain and disability index (SPADI), 36-Item Short Form Survey (SF-36), European Quality of Life Five Dimensions Five Level Scale (EQ-5D-5L), and Canadian Occupational Performance Measure (COPM) at the 6 assessment points: at baseline, 1-, 2-, 3-, 4.5- and 6-month. Results: There were no statistically significant differences in baseline PROM and 3-month PROM between the 2 groups. From baseline to 6 months, all PROM, all AROM, NRS, SPADI, COPM, SF-36 and EQ-5D-5L were significantly improved over time within each group in both groups (all P<0.001). However, there was no significant Group×Time interaction in any outcome, which means that the effect of time did not depend on which group the participants belonged to. Conclusion: AR and Kinect sensor-based telerehabilitation for participants with ACS improved shoulder pain, functional outcomes, and quality of life, but did not show superiority over conventional rehabilitation. ClinicalTrials.gov: