部分冈上肌撕裂的VR辅助康复治疗

实验性的：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.

行为的：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.

有源比较器：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.

行为的：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.

Pain intensity measured by the Numeric Rating Scale (NRS)

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.

Passive range of motion (ROM) of the affected shoulder

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.

Shoulder pain and disability measured using the Shoulder Pain and Disability Index (SPADI)

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.

Health-related quality of life measured using the Short Form-36 (SF-36)

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.

Kinesiophobia measured using the Tampa Scale of Kinesiophobia

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.

Supraspinatus tendon thickness measured using ultrasonography (USG)

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.