ChatGPT and DeepSeek-Assisted Rehabilitation in Subacromial Pain (LLM-RehabSP)

Effect of ChatGPT and DeepSeek-Guided Rehabilitation on Clinical Outcomes in Individuals With Subacromial Pain Syndrome

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.

Study Overview

• Status: Completed
• Conditions: Subacromial Pain Syndrome
• Intervention / Treatment: Behavioral: Conventional Exercise Program; Behavioral: ChatGPT-Guided Rehabilitation; Behavioral: DeepSeek-Guided Rehabilitation

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.

• Study Type: Interventional
• Enrollment (Actual): 75
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Merkez
    • Kırşehir, Merkez, Turkey (Türkiye), 40100
      • Kırşehir Ahi Evran University Training and Research Hospital, Physical Medicine and Rehabilitation Department

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Standard Exercise Group; Participants receive standard physiotherapy combined with a conventional exercise program for subacromial pain syndrome based on evidence-based clinical guidelines. Each group included 23 participants who completed the 6-week intervention and were included in the final analysis.	Behavioral: Conventional Exercise Program; Exercise protocol targeting subacromial pain syndrome, including shoulder mobility, strengthening, and posture correction exercises based on established clinical guidelines.
Experimental: DeepSeek-Guided Exercise Group; Participants receive standard physiotherapy combined with exercises generated by the DeepSeek-R1 large language model. Each group included 23 participants who completed the 6-week intervention and were included in the final analysis.	Behavioral: DeepSeek-Guided Rehabilitation; Personalized rehabilitation exercises generated by DeepSeek-R1 and implemented under physiotherapist guidance.
Experimental: ChatGPT-Guided Exercise Group; Participants receive standard physiotherapy combined with exercises generated by the ChatGPT-4o large language model. Each group included 23 participants who completed the 6-week intervention and were included in the final analysis.	Behavioral: ChatGPT-Guided Rehabilitation; AI-generated exercise recommendations from ChatGPT-4 tailored to the patient's profile and applied under physiotherapist supervision.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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).	Baseline and after 6 weeks of intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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).	Baseline and after 6 weeks of intervention
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).	Baseline and after 6 weeks of intervention
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.	Baseline and after 6 weeks
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.	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).	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).	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).	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).	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).	Baseline and after 6 weeks of intervention
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.	Baseline and after 6 weeks

Collaborators and Investigators

• Sponsor: Kirsehir Ahi Evran Universitesi

Study record dates

Study Major Dates

• Study Start (Actual): September 25, 2025
• Primary Completion (Actual): December 1, 2025
• Study Completion (Actual): December 20, 2025

Study Registration Dates

• First Submitted: August 3, 2025
• First Submitted That Met QC Criteria: August 23, 2025
• First Posted (Actual): August 29, 2025

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 26, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Artificial Intelligence; Subacromial Pain; Shoulder Rehabilitation; ChatGPT; Large Language Models; DeepSeek
• Other Study ID Numbers: 2025/874

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared due to ethical restrictions and institutional policy. The study was not designed with external data sharing in scope.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No