Effects of Virtual Reality-Assisted Task-Oriented Training on Clinical and Psychosocial Outcomes in Individuals with Rotator Cuff Tears: A Randomized Controlled Single-Blind Trial.

Abstract

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 (RCT). Prospective, single-blinded, two-arm, randomized controlled trial. Kırşehir Ahi Evran University Physical Therapy and Rehabilitation Clinic. Sixty individuals with partial RCT were randomized to the VR-TOT group (VR-TOTG, n = 30) or the control group (CG, n = 30). Both groups received six weeks of progressive conventional physiotherapy, while VR-TOTG additionally received VR-TOT based on activities of daily living. The primary outcome was upper extremity function assessed using DASH. Secondary outcomes included pain intensity (VAS), shoulder-related pain and disability (SPADI), kinesiophobia (TSK), pain catastrophizing (PCS), psychological status (HADS), and grip and pinch strength. For the primary outcome, the mean between-group difference in change in DASH was -3.93 points (95% CI, -4.79 to -3.08; p<0.001), 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=0.001), -1.23 cm for activity pain (95% CI, -1.53 to -0.94; p<0.001), -0.67 cm for night pain (95% CI, -0.87 to -0.46; p<0.001), -8.70 points for SPADI (95% CI, -10.29 to -7.11; p<0.001), -3.47 points for TSK (95% CI, -4.30 to -2.63; p<0.001), and -1.33 points for PCS (95% CI, -1.89 to -0.77; p<0.001), 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>0.05). Adding VR-TOT to conventional physiotherapy resulted in a statistically greater short-term improvement in DASH, the primary outcome, together 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 MCID, and longer-term studies are needed.