VR-Assisted Rehabilitation in Partial Supraspinatus Tears

This randomized controlled trial investigated the effects of immersive 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 and may be associated with restricted shoulder range of motion, reduced quality of life, and increased fear of movement. Conservative rehabilitation is commonly used as first-line treatment and typically includes physical therapy modalities together with exercises aimed at restoring shoulder mobility, rotator cuff function, and scapular control.

Virtual reality allows patients to perform repetitive, task-oriented upper-extremity movements within an interactive environment. Such systems may support active participation and provide visual feedback during movement; however, evidence regarding immersive virtual reality rehabilitation specifically in patients with partial supraspinatus tendon tears remains limited.

Participants with MRI-confirmed partial supraspinatus tendon tears were randomly allocated to either a virtual reality-assisted rehabilitation group or a conventional rehabilitation group. Both groups received a standardized physical therapy program consisting of hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation.

Following these physical therapy modalities, participants in the control group performed approximately 30 minutes of supervised conventional therapeutic exercises targeting shoulder mobility, stretching, strengthening, and scapular stabilization. Participants in the virtual reality group instead performed approximately 30 minutes of immersive virtual reality-based upper-extremity exercise. Thus, the virtual reality intervention replaced the conventional therapeutic exercise component rather than being added as an additional treatment, and the scheduled exercise duration was approximately equivalent between groups.

The intervention was delivered over 15 sessions during three weeks, with five sessions per week. Evaluations were performed at baseline and after completion of treatment.

The study evaluated pain intensity, passive shoulder range of motion, shoulder pain and disability, kinesiophobia, health-related quality of life, and supraspinatus tendon thickness measured by ultrasonography. The aim was to compare immersive virtual reality-based exercise with conventional therapeutic exercise when delivered within an otherwise similar rehabilitation program.

Inclusion criteria

• Aged 18 to 65 years
• Shoulder pain persisting for more than four weeks
• Partial supraspinatus tendon tear confirmed by shoulder magnetic resonance imaging

Exclusion criteria

• Physiotherapy treatment within the previous six months
• Shoulder injection within the previous six months
• History of tendon repair surgery
• Communication or cognitive impairment
• Vertigo, vestibular disorder, or another condition causing balance instability
• History of epilepsy or seizures
• Photosensitivity
• Diagnosed psychiatric condition, including an anxiety disorder or claustrophobia
• Additional orthopedic condition affecting the same shoulder
• Neurological, vascular, or cardiac disorder restricting functional capacity
• Pregnancy or breastfeeding