Virtual Reality Based Exercise Training Versus Mulligan Mobilization on Shoulder Posture and Function in Subacromial Impingement Syndrome

NCT07369934 | Recruiting DMC

• 1 other identifier: Virtual reality and Mulligan M
• Study Type: interventional
• Target: 74
• Locations: 1 country
• Sites: 1

Brief Summary

The study will compare the effect of virtual reality based exercise training versus Mulligan mobilization in addition to exercise therapy added to both groups on shoulder posture and function in subacromial impingement syndrome.

Conditions

Subacromial Impingement Syndrome

Keywords

subacromial impingement syndrome; Virtual reality; Mulligan mobilization; shoulder function; shoulder posture

Outcome Measures

Primary Outcomes (5)

• Pain intensity during shoulder elevation

  It will be measured using the Numerical Pain Rating Scale (NPRS)

  pain intensity at the start of session 1 to the end of 1 month of treatment

• Shoulder function

  The Shoulder Pain and Disability Index (SPADI) will be used to measure the shoulder function.

  shoulder function at the start of session 1 to the end of 1 month of treatment

• Shoulder flexion range of motion

  The Clinometer Application will be used to measure it.

  shoulder flexion at the start of session 1 to the end of 1 month of treatment

• Shoulder abduction range of motion

  The Clinometer Application will be used to measure it.

  shoulder abduction at the start of session 1 to the end of 1 month of treatment

• shoulder posture

  Sagittal Shoulder Angle will be used to measure the shoulder posture

  shoulder posture at the start of session 1 to the end of 1 month of treatment

Secondary Outcomes (2)

• Patients' enjoyment

  It will be evaluated at the end of the last session (after 1 month)

• patients' adherence to treatment sessions

  patients' adherence at the start of session 1 to the end of 1 month of treatment

Study Arms (2)

Virtual reality group

ACTIVE COMPARATOR

Other: Virtual Reality

Mulligan mobilization group

ACTIVE COMPARATOR

Other: Mulligan mobilization

Interventions

Virtual Reality OTHER

Fully immersive virtual reality mounted headset will be used

Virtual reality group

Mulligan mobilization OTHER

posterolateral shoulder Mulligan mobilization with movement (MWM) will be used

Mulligan mobilization group

Eligibility Criteria

• Age: 30 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients will be referred from the orthopedic surgeon with a diagnosis of stage II SIS with the following criteria:
• Participants ranged in age from 30-50 years old.
• Participants are from non-athletes from the general population.
• Unilateral shoulder pain that is localized either anteriorly or laterally to the acromion. Pain that occurs or worsens when the affected shoulder is in flexion and/or abduction.
• Four of the following should be present in the included patients: Neer impingement test, Hawkins' test, Pain was replicated in the supraspinatus empty-can test, a painful arc of movement from 70° to 120°, and painful greater tuberosity of the humerus.
• BMI range 18.5- 29.9 Kg/m².

You may not qualify if:

• \) Patients who, during the previous three months, underwent shoulder physical treatment and/or an acute pain flare.
• \) Patients who have undergone surgeries for tendon repair. 3) Malignancy, epilepsy, pregnant women, and/or systemic conditions like chronic renal or liver failure.
• \) Mini-Mental State Examination test (MMSE) (\< 24/30) to exclude cognitive impairment and/or significant vision impairment (if they couldn't read the introduction while wearing the Head Mounted Device (HMD).
• \) Corticosteroid injection during the last three months or used steroids chronically.
• \) Adhesive capsulitis, glenohumeral joint instability, Numbness or tingling of the upper limb, and/or full-thickness tear of the rotator cuff.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Cairo University

Giza, Egypt

RECRUITING

Related Publications (12)

• Steiner, B., Elgert, L., Saalfeld, B., & Wolf, K. H. (2020). Gamification in rehabilitation of patients with musculoskeletal diseases of the shoulder: scoping review. JMIR serious games, 8(3), e19914. https://doi.org/10.2196/19914

  BACKGROUND

• Smith, J., & Doe, A. (2023). Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: An experimental study. Journal of Rehabilitation Science, 45(2), 123-134.

  BACKGROUND

• Lin, H. T., Li, Y. I., Hu, W. P., Huang, C. C., & Du, Y. C. (2019). A scoping review of the efficacy of virtual reality and exergaming on patients of musculoskeletal system disorder. Journal of clinical medicine, 8(6), 791. https://doi.org/10.3390/jcm8060791

  BACKGROUND

• Hoyek, N., Di Rienzo, F., Collet, C., Hoyek, F., & Guillot, A. (2014). The therapeutic role of motor imagery on the functional rehabilitation of a stage II shoulder impingement syndrome. Disability and rehabilitation, 36(13), 1113-1119.

  BACKGROUND

• Consigliere, P., Haddo, O., Levy, O., & Sforza, G. (2018). Subacromial impingement syndrome: management challenges. Orthopedic research and reviews, 83-91. https://doi.org/10.2147/ORR.S157864

  BACKGROUND

• Coja, D. M., Onu, I., Onu, A., Iordan, D. A., Gheorghiu, G., Ene-Voiculescu, V., & Talaghir, L. G. (2024). The Use of Virtual Reality-Assisted Therapy to Improve Shoulder function in Subacromial Impingement Syndrome: a Randomised Controlled Trial. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 15(4), 11-26. http://dx.doi.org/10.70594/brain/15.4/2

  BACKGROUND

• Chaplin, E., Karatzios, C., & Benaim, C. (2023, December). Clinical applications of virtual reality in musculoskeletal rehabilitation: A scoping review. In Healthcare (Vol. 11, No. 24, p. 3178). MDPI. https://doi.org/10.3390/healthcare11243178

  BACKGROUND

• Álvarez de la Campa Crespo, M., Donegan, T., Amestoy-Alonso, B., Just, A., Combalía, A., & Sanchez-Vives, M. V. (2023). Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: An experimental study. Journal of Orthopaedic Surgery and Research, 18(1), 729. https://doi.org/10.1186/s13018-023-04158-w

  BACKGROUND

• Özlü, A., Üstündağ, S., Bulut Özkaya, D., & Menekşeoğlu, A. K. (2024). Effect of exergame on pain, function, and quality of life in shoulder impingement syndrome: a prospective randomized controlled study. Games for Health Journal, 13(2), 109-119. https://doi.org/10.1089/g4h.2023.0108

  RESULT

• Gumaa, M., & Rehan Youssef, A. (2019). Is virtual reality effective in orthopedic rehabilitation? A systematic review and meta-analysis. Physical therapy, 99(10), 1304-1325. https://doi.org/10.1093/ptj/pzz093

  RESULT

• Dias, D., Neto, M. G., Sales, S. D. S. R., Cavalcante, B. D. S., Torrierri Jr, P., Roever, L., & Araujo, R. P. C. D. (2023). Effect of mobilization with Movement on Pain, disability, and Range of Motion in patients with Shoulder Pain and Movement Impairment: a systematic review and Meta-analysis. Journal of Clinical Medicine, 12(23), 7416. https://doi.org/10.3390/jcm12237416

  RESULT

• Delgado-Gil, J. A., Prado-Robles, E., Rodrigues-de-Souza, D. P., Cleland, J. A., Fernández-de-las-Peñas, C., & Alburquerque-Sendín, F. (2015). Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial. Journal of manipulative and physiological therapeutics, 38(4), 245-252. https://doi.org/10.1016/j.jmpt.2014.12.008

  RESULT

MeSH Terms

Conditions

Shoulder Impingement Syndrome

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Shoulder Injuries; Wounds and Injuries

Study Officials

• Enas Fawzy Youssed, Professor Doctor

  Cairo University

  STUDY CHAIR

• Afaf M Tahoon, lecturer

  Cairo University

  STUDY DIRECTOR

• Mohamed A Kotb, Assistant professor

  Cairo University

  STUDY DIRECTOR

Central Study Contacts

Sara M Meselhy, Demonstrator

CONTACT

+01222518092; sara.mohsen@cu.edu.eg

Afaf M Tahoon, lecturer

CONTACT

+01015401783; Afaf_tahoon@cu.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Demonstrator at the Faculty of Physical Therapy, Cairo University

Study Record Dates

• First Submitted: January 12, 2026
• First Posted: January 27, 2026
• Study Start: December 13, 2025
• Primary Completion: May 1, 2026
• Study Completion: May 1, 2026
• Last Updated: January 27, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)