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This randomized controlled trial aims to investigate the effects of virtual reality-assisted rehabilitation in patients with partial supraspinatus tendon tears. Virtual reality has emerged as a promising tool to enhance patient engagement and improve rehabilitation outcomes in musculoskeletal disorders; however, evidence in this patient population remains limited. Participants will be assigned to either a virtual reality-assisted rehabilitation group or a conventional rehabilitation group. Both groups will receive a structured physical therapy program, while the intervention group will additionally perform virtual reality-based exercises. The study will evaluate the potential benefits of virtual reality in improving clinical outcomes compared to conventional rehabilitation.
This study aims to investigate the effects of virtual reality-assisted rehabilitation on pain, kinesiophobia, quality of life, and supraspinatus tendon thickness in patients with partial supraspinatus tendon tears.
Partial supraspinatus tears are a common cause of shoulder pain and functional limitation, often leading to decreased quality of life and increased fear of movement. Virtual reality (VR) has emerged as an innovative rehabilitation tool that may enhance patient engagement and treatment adherence.
This study is designed as a randomized controlled trial to evaluate the effectiveness of virtual reality-assisted rehabilitation in patients with partial supraspinatus tendon tears.
Partial supraspinatus tendon tears are a common cause of shoulder pain and functional impairment, often associated with reduced range of motion, decreased quality of life, and increased kinesiophobia. Conventional rehabilitation approaches are widely used; however, patient adherence and engagement may be limited.
Participants diagnosed with partial supraspinatus tendon tears will be randomly allocated to either a virtual reality-assisted rehabilitation group or a conventional rehabilitation group. Both groups will receive a standardized physical therapy program including hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. In addition, participants in the virtual reality group will perform interactive, task-oriented exercises using virtual reality applications designed to enhance motivation and active participation. The control group will perform conventional therapeutic exercises targeting shoulder mobility, strength, and function.
All interventions will be applied over a structured treatment period under the supervision of a physiotherapist. Evaluations will be conducted at baseline and after completion of the intervention period.
This study aims to determine whether the integration of virtual reality into conventional rehabilitation provides additional clinical benefits in terms of pain reduction, functional improvement, and patient engagement in individuals with partial supraspinatus tendon tears.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| virtual reality group | Experimental | Participants in the experimental group received the same conventional treatment protocol and additionally performed virtual reality (VR)-assisted exercises. A Meta Quest Pro VR headset (Meta Platforms Inc.) was used to provide an immersive virtual environment during the intervention. |
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| Control Group | Active Comparator | participants performed a set of therapeutic exercises after the same conventional treatment protocol |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VR-assisted rehabilitation program | Behavioral | Participants in the experimental group received the same conventional physiotherapy program as the control group and additionally performed virtual reality (VR)-assisted exercises. A Meta Quest Pro VR headset (Meta Platforms Inc.) was used to provide an immersive virtual environment during the intervention. The system provides high-resolution optics, a wide field of view, and six degrees of freedom (6DoF) motion tracking, allowing accurate tracking of upper extremity movements. VR-based exercises were designed to promote repetitive shoulder and upper limb movements through interactive, task-oriented activities within a three-dimensional virtual environment. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity measured by the Numeric Rating Scale (NRS) | Pain intensity was evaluated using an 11-point Numeric Rating Scale (NRS). Participants were asked to indicate the severity of their shoulder pain by selecting a number between 0 and 10, where 0 represented the absence of pain and 10 represented the most severe pain imaginable.Measurements were obtained both at rest and during shoulder movement, and the reported values were recorded as the participants' pain scores | Baseline and after 3 weeks of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Passive range of motion (ROM) of the affected shoulder | shoulder ROM, including flexion, extension, abduction, internal rotation, and external rotation, was measured using a universal goniometer (Saehan Goniometer) within the tolerable range of motion | Baseline and after 3 weeks of treatment |
| Shoulder pain and functional impairment were assessed using the Shoulder Pain and Disability Index (SPADI) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hitit University Erol Olçok Research Hospital Physical Medicine and Rehabilitation Clinic | Çorum | 19000 | Turkey (Türkiye) |
Individual participant data will not be shared due to institutional regulations and the absence of participant consent for public data sharing.
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| ID | Term |
|---|---|
| D020069 | Shoulder Pain |
| D000092442 | Kinesiophobia |
| ID | Term |
|---|---|
| D018771 | Arthralgia |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D010146 | Pain |
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Participants were randomly assigned in a 1:1 ratio to either the virtual reality-assisted rehabilitation group or the conventional exercise group. Both groups received the same standard physiotherapy modalities, while the experimental group additionally performed VR-based exercises.
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| Conventional shoulder exercise program | Behavioral | After completion of the standard physiotherapy modalities, participants performed a set of therapeutic exercises aimed at improving shoulder mobility and coordination of the shoulder girdle muscles |
|
SPADI, a 13-item questionnaire consisting of pain (5 items) and disability (8 items) subscales. Each item is scored on a 0-10 scale, and total scores are expressed as percentages ranging from 0 to 100, with higher scores indicating greater pain and disability |
| Baseline and after 3 weeks of treatment |
| Health-related quality of life was evaluated using the Short Form-36 (SF-36) questionnaire | SF-36 questionnaire, which includes 36 items across eight domains: physical functioning, role limitations due to physical problems, bodily pain, general health perception, vitality, social functioning, role emotional limitations, and mental health. Domain scores range from 0 to 100, with higher scores indicating better health status. | Baseline and after 3 weeks of treatment |
| Fear of movement and reinjury was assessed using the Tampa Scale of Kinesiophobia (TAMPA) | TAMPA, a 17-item questionnaire scored on a four-point Likert scale. Total scores range from 17 to 68, with higher scores reflecting greater kinesiophobia | Baseline and after 3 weeks of treatment |
| The supraspinatus tendon thickness was measured using Ultrasonography(USG) | The supraspinatus tendon thickness was measured using USG with the shoulder positioned in extension and external rotation, and the hand placed on the gluteal region. Tendon thickness was recorded according to the EURO-MUSCULUS standardized protocol. All ultrasonographic measurements were performed by the same experienced physician. | Baseline and after 3 weeks of treatment |
| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010698 | Phobic Disorders |
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |