Comparison of the effectiveness of virtual reality-based exercises with conventional exercises in the treatment of shoulder adhesive capsulitis

Adhesive capsulitis (AC), also known as shoulder periarthritis, is a condition that causes functional limitations in active and passive shoulder joint movements. The effect of virtual reality (VR)-based exercise programmes, an innovative application that has recently begun to be used in the field of physical therapy, on AC patients is not fully known. This study was designed as a single-blind, randomised controlled trial to compare the effectiveness of VR and conventional exercise programmes for the treatment of AC and to evaluate whether they are more effective than the control group. A total of 90 patients diagnosed with AC were divided into three groups using a computer-assisted randomisation method. The VR-based exercise programme consisted of 15 sessions over 5 days per week, the conventional exercise programme consisted of 15 sessions over 5 days per week, and the home exercise programme consisted of 15 sessions over 5 days per week for all groups. The first group received VR-based exercises and the home exercise programme, the second group received conventional exercises and the home exercise programme, and the third group received only the home exercise programme. Patients were assessed for pain (VAS), mobility (ROM), and functionality (mCMS and SPADI) before treatment, at the end of treatment (Week 3), and at Week 12. Significant improvements in pain, ROM, and functionality were observed in all three groups compared to baseline. Improvements in VAS activity, night, and rest values at week 3 and week 12 were statistically significant in the VR and conventional groups compared to the control group (p<0.05). When examining shoulder ROM scores, the increase in active flexion, abduction, and external rotation at 3 weeks and 12 weeks in the control group was statistically significant in the VR group compared to the conventional and control groups (p<0.05). At week 12, improvements in passive shoulder flexion, abduction, and external rotation were statistically significant in the VR group compared to the control group (p<0.05). When mCMS was examined, functional improvement in the VR group at the 3-week follow-up was significantly higher than in the conventional and control groups (p<0.05). When considering mCMS at the 12th week follow-up, functional improvement in the VR group was significantly higher than in the other two groups (p<0.05); additionally, improvement in the conventional group was statistically significant compared to the control group (p<0.05). When SPADI values were considered, functional improvement in the VR group at the 3-week control was statistically significant compared to the control group (p<0.05). At the 12-week control, SPADI in the VR group showed significantly higher functional improvement compared to the other two groups (p<0.05). In conclusion, it was observed that the VR-based exercise programme had positive effects on pain, ROM, and functionality in AC patients. Additionally, it is considered that the VR-based exercise programme provides superior effects on shoulder ROM and functionality compared to the conventional exercise programme.