Effectiveness of Telerehabilitation in the Treatment of Shoulder Injuries: A Systematic Review of Randomized Clinical Trials.

Only five trials were included, covering 196 people in total, and several had fewer than 20 people per group. That is far too little to conclude that telerehabilitation is equivalent to in-person care. The review did not combine the results of the trials. It describes them one by one, so there is no overall estimate of how well telerehabilitation works. The authors say they assessed risk of bias and rated the certainty of the evidence with GRADE, but none of those assessments are reported, so a reader cannot judge how trustworthy the individual trials are. The trials studied quite different people: adults with impingement or capsulitis, working-age adults with chronic shoulder pain, young men with upper cross syndrome, boys and young men with Duchenne muscular dystrophy, and patients recovering from rotator cuff surgery. One conclusion covers all of them. The comparison groups were not the same thing. One trial compared telerehabilitation with supervised in-person therapy; others compared it with home video exercises, with counselling alone, or with another telerehabilitation programme. Session frequency, session length and total programme duration varied widely (3 to 5 times a week, 20 to 40 minutes, 2 to 12 weeks), and two trials did not report how long each session lasted. One included study was a feasibility trial testing whether a programme could be delivered, not whether it worked. The search covered only 2019 to 2024 and only English or Spanish publications, so earlier and non-English trials were missed. Patients without reliable internet, a suitable device or digital confidence were not represented. The authors list technological infrastructure, data security, accessibility and digital literacy as unresolved barriers. Chronic shoulder instability is specifically named as still lacking robust evidence for telerehabilitation.

The text supplied contains no funding statement and no competing-interest declaration. The review records a PROSPERO registration. The only commercial names given are the suppliers of software and devices used by the included trials (Rayyan, Playball, Zoom), listed in a supplier note at the end of the article.

Do not read this as proof that telerehabilitation matches in-person care for shoulder injuries. It rests on five small trials with 196 people in total, the review never combined their results, and several of the trials compared telerehabilitation with home exercises, counselling or another telerehabilitation programme rather than with face-to-face therapy. The authors also say they assessed risk of bias and rated the certainty of the evidence, but none of those assessments appear in the paper.