VR-Assisted Rehabilitation in Partial Supraspinatus Tears

September 10, 2026 updated by: Pınar Özge Başaran, Hitit University

Effects of Virtual Reality-Assisted Rehabilitation on Pain, Kinesiophobia, Quality of Life, and Supraspinatus Tendon Thickness in Patients With Partial Supraspinatus Tears: A Randomized Controlled Trial

This randomized controlled trial investigated the effects of virtual reality-assisted rehabilitation in patients with partial supraspinatus tendon tears. Partial supraspinatus tears are a common cause of shoulder pain, functional limitation, restricted range of motion, and fear of movement. Conservative rehabilitation is commonly used as first-line treatment, while evidence regarding immersive virtual reality rehabilitation in this patient population remains limited.

Participants were randomly allocated to either a virtual reality-assisted rehabilitation group or a conventional rehabilitation group. Both groups received the same physical therapy modalities, including hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. The control group subsequently performed conventional therapeutic shoulder exercises, whereas the virtual reality group performed approximately equal-duration immersive VR-based exercises instead of the conventional exercise component. Outcomes included pain, shoulder range of motion, disability, kinesiophobia, health-related quality of life, and supraspinatus tendon thickness.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

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.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
52

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Çorum
      • Çorum, Çorum, Turkey (Türkiye), 19000
        • Hitit University Erol Olçok Research Hospital Physical Medicine and Rehabilitation Clinic

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: virtual reality group
Participants received the same physical therapy modalities as the control group, consisting of hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. They subsequently performed approximately 30 minutes of immersive virtual reality-based upper-extremity exercise using a Meta Quest Pro headset instead of the conventional therapeutic exercise component. The virtual reality exercise was therefore a replacement rather than an additional treatment.
Behavioral: VR-assisted rehabilitation program
Participants received physical therapy modalities consisting of hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. They subsequently performed approximately 30 minutes of immersive virtual reality-based upper-extremity exercise using a Meta Quest Pro headset instead of the conventional therapeutic shoulder exercise component. The virtual reality activities involved repetitive, task-oriented shoulder and upper-extremity movements within an interactive three-dimensional environment. The intervention was delivered five days per week for three weeks, for a total of 15 sessions.
Active Comparator: Control Group
Participants received physical therapy modalities consisting of hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation. They subsequently performed approximately 30 minutes of supervised conventional therapeutic shoulder exercises targeting shoulder mobility, stretching, strengthening, and scapular stabilization.
Behavioral: Conventional shoulder exercise program
After receiving physical therapy modalities consisting of hot pack, therapeutic ultrasound, and transcutaneous electrical nerve stimulation, participants performed approximately 30 minutes of supervised conventional therapeutic shoulder exercise. The program included scapular mobilization; stretching exercises for shoulder flexion, abduction, internal rotation, and external rotation; and strengthening exercises for the shoulder and scapular stabilizer muscles. Exercises were performed in three sets of 10 repetitions. The intervention was delivered five days per week for three weeks, for a total of 15 sessions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain intensity measured by the Numeric Rating Scale (NRS)
Time Frame: Baseline and after 3 weeks of treatment
Pain intensity at rest and during shoulder movement was assessed separately using an 11-point Numeric Rating Scale, ranging from 0 (no pain) to 10 (the worst pain imaginable). Higher scores indicated greater pain intensity.
Baseline and after 3 weeks of treatment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Passive range of motion (ROM) of the affected shoulder
Time Frame: Baseline and after 3 weeks of treatment
Passive range of motion of the affected shoulder, including flexion, extension, abduction, internal rotation, and external rotation, was measured in degrees using a Saehan goniometer. Higher values indicated greater range of motion.
Baseline and after 3 weeks of treatment
Shoulder pain and disability measured using the Shoulder Pain and Disability Index (SPADI)
Time Frame: Baseline and after 3 weeks of treatment
The Shoulder Pain and Disability Index is a 13-item questionnaire comprising a five-item pain subscale and an eight-item disability subscale. Pain, disability, and total scores are expressed on a scale from 0 to 100, with higher scores indicating greater pain and disability.
Baseline and after 3 weeks of treatment
Health-related quality of life measured using the Short Form-36 (SF-36)
Time Frame: Baseline and after 3 weeks of treatment
The Short Form-36 is a 36-item questionnaire comprising eight domains: physical functioning, role limitations due to physical health, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems, and mental health. Each domain is scored from 0 to 100, with higher scores indicating better health status.
Baseline and after 3 weeks of treatment
Kinesiophobia measured using the Tampa Scale of Kinesiophobia
Time Frame: Baseline and after 3 weeks of treatment
The Tampa Scale of Kinesiophobia is a 17-item questionnaire scored using a four-point Likert scale. Total scores range from 17 to 68, with higher scores indicating greater fear of movement or reinjury.
Baseline and after 3 weeks of treatment
Supraspinatus tendon thickness measured using ultrasonography (USG)
Time Frame: Baseline and after 3 weeks of treatment
Supraspinatus tendon thickness was measured with the participant seated and the affected arm placed in the modified Crass position. Using a Logiq V2 portable ultrasound device, the transducer was positioned longitudinally over the supraspinatus tendon, and tendon thickness was measured at the point of maximal thickness and recorded in centimeters. The measurement procedure was based on the EURO-MUSCULUS shoulder scanning protocol.
Baseline and after 3 weeks of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Hitit University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 1, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 20, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 20, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 12, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 12, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 18, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 15, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 10, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2024-144

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to institutional regulations and the absence of participant consent for public data sharing.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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