Physiother Theory Pract. 2025 Jul 2:1-12. doi: 10.1080/09593985.2025.2526021. Online ahead of print.ABSTRACTBACKGROUND: Shoulder pain is one of the most common musculoskeletal complaints, increasing with age and affecting many functions.PURPOSE: To compare the effects of synchronized telerehabilitation and face-to-face rehabilitation approaches in terms of pain, function, and muscle activation in patients with partial rotator-cuff (RC) tears.METHODS: 44 patients with partial RC tear were randomly separated into two groups (Group-1:Telerehabilitation; Group-2: Face-to-face rehabilitation). Pain levels were assessed using a Visual Analogue Scale (VAS), shoulder function using the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, muscle activation levels using a superficial electromyogram (sEMG), and satisfaction levels using the Global Rating of Change (GRC) and the Telehealth Satisfaction Scale (TSS).RESULTS: The mean ages of the groups were 55.55 years (±7.01) and 57.00 years (±8.12), respectively. The VAS-rest score at Week 4 and the VAS-activity score at Weeks 4 and 8 showed a significant difference in favor of Group 2 (p < .001; p < .001; p = .01, respectively). Significant improvements were seen in DASH (p < .001,ES=.85; p < .001, ES = .89) scores and sEMG activation of the infraspinatus (p < .001, ES = .69; p < .001, ES = 81), upper trapezius (p < .001, ES = .28; p < .001, ES = .33, respectively), anterior deltoid(p < .001,ES=.92; p < .001, ES = .94), middle deltoid(p < .001, ES = .66; p < .001, ES = .68), and posterior deltoid (p = .002, ES = .92; p < .001, ES = .93) muscles, in both groups. No significant differences were found in GRC scores.CONCLUSION: Face-to-face rehabilitation is more effective at relieving pain. Synchronized telerehabilitation is a feasible way to improve shoulder function, muscle activation, and patient satisfaction.Clinical Trial URL/Registration Number: https://clinicaltrials.gov/NCT05904249.PMID:40601531 | DOI:10.1080/09593985.2025.2526021