Virtual Reality Versus Traditional Exercise on EMG Activity in Postural Malalignment (EMG)

September 27, 2026 updated by: Mohamed Abdelmegeed, Hofstra University

Influence of Virtual Reality Versus Traditional Exercise on Trapezius Muscle EMG Activity in Relaxed and Corrected Postures Among Individuals With and Without Postural Malalignment

This study aims to investigate the immediate effects of virtual reality (VR)-based exercise compared with traditional Active free exercise on trapezius muscle activation in adults with and without postural malalignment. Surface electromyography (EMG) will be used to assess upper, middle, and lower trapezius muscle activity during relaxed and corrected postures and during VR and traditional exercise. Demographic data will be collected. The study will also assess posture, trapezius muscle strength, cervical range of motion, Activity level, craniovertebral angle, and neck proprioception. Approximately 40 adults aged 18-35 years will participate in a single study session. The findings may help determine whether VR-based rehabilitation provides an effective and engaging approach for assessing and training postural control and trapezius muscle activation.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

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 study will investigate the immediate effects of virtual reality (VR)-based exercise compared with traditional exercise on trapezius muscle activation in adults with and without postural malalignment. The study will include approximately 40 adults aged 18-35 years. Participants will be classified according to the presence or absence of postural abnormalities and symptoms.

At baseline, demographic and clinical information will be collected, followed by assessment of forward head posture, rounded shoulder posture, trapezius muscle strength, cervical range of motion, Activity level, craniovertebral angle and joint position sense. Forward head posture will be assessed using the craniovertebral angle obtained through digital photogrammetry, while rounded shoulder posture will be evaluated using the acromion-to-table distance. Symptomatic participants will additionally complete the Numeric Pain Rating Scale (NPRS) and Neck Disability Index (NDI).

Surface electromyography (sEMG) will be used to record the activity of the upper, middle, and lower trapezius muscles. EMG activity will be assessed during relaxed and corrected standing postures and continuously during the exercise conditions. EMG data will be normalized to maximum voluntary isometric contraction (MVIC) and expressed as a percentage of MVIC.

Each participant will complete both the VR-based intervention and the traditional TheraBand exercise intervention during a single study session. The VR intervention will be performed using a Virtualis rehabilitation system with an HTC Vive headset and motion controllers and will involve controlled upper-extremity movements designed to promote appropriate scapular and postural control. The traditional exercise condition will include standing active free exercises targeting the upper, middle, and lower trapezius muscles. A rest period will be provided between the two exercise conditions to minimize the potential effects of fatigue.

The primary comparison will examine normalized trapezius muscle activation during the VR-based and active free exercise conditions. Additional assessments will examine posture, trapezius muscle strength, cervical range of motion, and cervical proprioception. The study is intended to provide information regarding the immediate neuromuscular responses to VR-based rehabilitation and its potential application as an interactive approach to postural rehabilitation.

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 (Estimated)

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.
40

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 Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

  • Name: Dina Alhamaky, Ph.D. in Physical Therapy
  • Phone Number: +971503963450
  • Email: dinaali2008@cu.edu.eg

Study Locations

  • United States
    • New York
      • Hempstead, New York, United States, 11549
        • Hofstra University

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

18 years to 35 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

participants will include healthy individuals or individuals with postural malalignment.

  • Age 18-35 years
  • Able to provide written informed consent
  • Able to stand and perform light movement tasks safely
  • Normal or corrected-to-normal vision
  • Sufficient intellectual ability to understand and follow instructions
  • Basic English proficiency to understand study instructions and questionnaires
  • For symptomatic participants, presence of postural dysfunction at baseline, including one or more of the following:
  • Forward head posture
  • Rounded shoulder posture

Exclusion Criteria:

  • - Epilepsy
  • Severe balance disorders
  • Major neurological or musculoskeletal conditions
  • Recent injuries
  • Use of medications affecting balance
  • Pregnancy

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

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: VR and Traditional Exercise

Participants will complete both a virtual reality (VR)-based exercise intervention and a traditional exercise intervention during a single study session. Trapezius muscle activity will be recorded using surface electromyography (sEMG) during both exercise conditions, with a rest period provided between interventions to minimize fatigue.
Other: Virtual reality exercise

Participants will perform a Virtualis virtual reality rehabilitation activity using an HTC Vive headset and motion controllers while standing. The activity involves controlled upper-extremity reaching movements designed to encourage scapular retraction and depression and maintenance of an upright head and trunk posture. Trapezius muscle activity will be recorded continuously using surface electromyography (sEMG)

Other: Active free Exercise

Participants will perform standing Active free exercises targeting the upper, middle, and lower trapezius muscles. Exercises will include diagonal arm elevation, horizontal abduction, and shoulder elevation. The duration of exercise during the active free condition will be matched to the duration of the VR intervention. Trapezius muscle activity will be recorded continuously using surface electromyography (sEMG).

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
Trapezius Muscle Activation (sEMG)
Time Frame: During the single study session (approximately 35-45 minutes)

Surface electromyography (sEMG) will be used to measure upper, middle, and lower trapezius muscle activation during the virtual reality and Active free exercise conditions. EMG activity will be normalized to maximum voluntary isometric contraction (MVIC) and expressed as %MVIC.
During the single study session (approximately 35-45 minutes)

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.
Hofstra University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Mohamed Abdelmegeed, Ph.D. in Physical Therapy, Hofstra 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 (Estimated)

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.
October 25, 2026

Primary Completion (Estimated)

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.
August 25, 2027

Study Completion (Estimated)

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.
October 25, 2027

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).
September 27, 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.
September 27, 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.
October 2, 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.
October 2, 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 27, 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.
  • 20260723-AHK-SHS-ABD-1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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