Effects of Virtual Reality-Assisted Task-Oriented Training on Clinical and Psychosocial Outcomes in Individuals With...

The aim of this randomized controlled study was to examine the effects of virtual reality-assisted task-oriented training (VR-TOT) added to conventional physiotherapy in individuals with rotator cuff tears.

Prospective, single-blinded, 2-arm, randomized controlled trial.

An outpatient physical therapy and rehabilitation clinic.

A total of 60 individuals with partial rotator cuff tears were randomized to the VR-TOT group (VR-TOTG, n=30) or the control group (n=30).

Both groups received 6 weeks of progressive conventional physiotherapy, whereas the VR-TOTG additionally received VR-TOT based on activities of daily living.

The primary outcome was upper extremity function assessed using the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). Secondary outcomes included pain intensity (visual analog scale), shoulder-related pain and disability (Shoulder Pain and Disability Index [SPADI]), kinesiophobia (Tampa Scale for Kinesiophobia [TSK]), pain catastrophizing (Pain Catastrophizing Scale [PCS]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and grip and pinch strength.

For the primary outcome, the mean between-group difference in change in DASH was -3.93 points (95% confidence interval [CI], -4.79 to -3.08; P<.001), favoring the VR-TOTG. For the secondary outcomes, the mean between-group differences in change were -0.53 cm for resting pain (95% CI, -0.84 to -0.22; P=.001), -1.23 cm for activity pain (95% CI, -1.53 to -0.94; P<.001), -0.67 cm for night pain (95% CI, -0.87 to -0.46; P<.001), -8.70 points for SPADI (95% CI, -10.29 to -7.11; P<.001), -3.47 points for TSK (95% CI, -4.30 to -2.63; P<.001), and -1.33 points for PCS (95% CI, -1.89 to -0.77; P<.001), favoring the VR-TOTG. Between-group differences were not significant for HADS anxiety, HADS depression, HADS total score, hand grip strength, or pinch strength (P>.05).

Adding VR-TOT to conventional physiotherapy resulted in a statistically greater short-term improvement in DASH, the primary outcome, along with additional improvements in pain, shoulder-related pain and disability, kinesiophobia, and pain catastrophizing. However, the between-group DASH difference did not reach the published minimal clinically important difference, and longer-term studies are needed.