ChatGPT and DeepSeek-Assisted Rehabilitation in Subacromial Pain

Kirsehir Ahi Evran Universitesi75 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

Interventions

Conventional Exercise ProgramBEHAVIORAL

Exercise protocol targeting subacromial pain syndrome, including shoulder mobility, strengthening, and posture correction exercises based on established clinical guidelines.

ChatGPT-Guided RehabilitationBEHAVIORAL

AI-generated exercise recommendations from ChatGPT-4 tailored to the patient's profile and applied under physiotherapist supervision.

DeepSeek-Guided RehabilitationBEHAVIORAL

Personalized rehabilitation exercises generated by DeepSeek-R1 and implemented under physiotherapist guidance.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Change in Disability (Shoulder Pain and Disability Index, SPADI)

Disability related to shoulder pain will be measured.Shoulder Pain and Disability Index (0-100; higher scores indicate worse disability).

Time frame: Baseline and after 6 weeks of intervention

Secondary Outcomes

Change in upper extremity function (Quick DASH)

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.

Time frame: Baseline and after 6 weeks

Change in shoulder range of motion (ROM)

Active range of motion in shoulder flexion, extension, abduction, internal and external rotation will be measured using a standard manual goniometer.

Time frame: Baseline and after 6 weeks

Change in Quality of Life (Short Form-12, SF-12)

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).

Time frame: Baseline and after 6 weeks of intervention

Change in Pain Intensity (Numeric Pain Rating Scale, NPRS)

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).

Time frame: Baseline and after 6 weeks of intervention

Change in shoulder and elbow muscle strength (K-Force)

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.

Time frame: Baseline and after 6 weeks

Change in Kinesiophobia (Tampa Scale for Kinesiophobia, TSK)

Kinesiophobia will be measured using the Tampa Scale for Kinesiophobia (TSK). Tampa Scale for Kinesiophobia (17-68; higher scores indicate greater fear of movement).

Time frame: Baseline and after 6 weeks

Change in shoulder function (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, ASES)

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).

Time frame: Baseline and after 6 weeks

Change in Pain Catastrophizing (Pain Catastrophizing Scale, PCS)

Pain catastrophizing will be assessed.Pain Catastrophizing Scale (0-52; higher scores indicate worse catastrophizing).

Time frame: Baseline and after 6 weeks of intervention

Change in Emotional Status (Hospital Anxiety and Depression Scale, HADS)

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).

Time frame: Baseline and after 6 weeks of intervention

Change in disease-specific quality of life (Western Ontario Rotator Cuff Index, WORC)

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).

Time frame: Baseline and after 6 weeks of intervention

ChatGPT and DeepSeek-Assisted Rehabilitation in Subacromial Pain

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes