Virtual reality exercise versus Mulligan mobilization for shoulder posture and function in subacromial impingement

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

This trial will test whether virtual reality–based exercises or Mulligan mobilization, each added to exercise therapy, better improve shoulder posture and function in adults aged 30–50 with subacromial impingement syndrome.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 74 (estimated)
• Ages: 30 Years to 50 Years
• Sex: All
• Sponsor: Cairo University (Academic / other)
• Locations: 1 site (Giza)
• Trial ID: NCT07369934 on ClinicalTrials.gov

What this trial studies

Adults with unilateral stage II subacromial impingement will be enrolled at the Faculty of Physical Therapy, Cairo University and assigned to receive either virtual reality–based exercise training or Mulligan mobilization, with exercise therapy provided to both groups. Baseline and follow-up measures of shoulder posture and functional outcomes will be collected to compare the two approaches. Inclusion criteria include age 30–50, non-athletes, specific positive impingement tests, unilateral pain, and BMI 18.5–29.9 kg/m², while recent shoulder treatment, prior tendon repair surgery, malignancy, epilepsy, pregnancy, or systemic conditions are excluded. Treatments are delivered in person at the study site and outcome changes will be analyzed between the groups.

Who should consider this trial

Good fit: Ideal candidates are non-athlete adults aged 30–50 with unilateral stage II subacromial impingement confirmed by specific clinical tests, BMI 18.5–29.9 kg/m², and no recent shoulder physical therapy or surgery.

Not a fit: Patients who recently had shoulder treatment or surgery, those with acute flares, malignancy, epilepsy, pregnancy, systemic illnesses, or BMI outside the specified range are unlikely to qualify or benefit from this protocol.

Why it matters

Potential benefit: If successful, the approach that performs better could offer a non-surgical way to reduce pain and improve shoulder posture and function for people with subacromial impingement.

How similar studies have performed: Previous small trials and reviews have reported that both virtual reality rehabilitation and Mulligan mobilization can improve shoulder pain and function, but direct head-to-head comparisons are limited.

Eligibility criteria

Inclusion Criteria:

* Patients will be referred from the orthopedic surgeon with a diagnosis of stage II SIS with the following criteria:

  1. Participants ranged in age from 30-50 years old.
  2. Participants are from non-athletes from the general population.
  3. 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.
  4. 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.
  5. BMI range 18.5- 29.9 Kg/m².

Exclusion Criteria:

* 1\) Patients who, during the previous three months, underwent shoulder physical treatment and/or an acute pain flare.

  2\) Patients who have undergone surgeries for tendon repair. 3) Malignancy, epilepsy, pregnant women, and/or systemic conditions like chronic renal or liver failure.

  4\) 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).

  5\) Corticosteroid injection during the last three months or used steroids chronically.

  6\) Adhesive capsulitis, glenohumeral joint instability, Numbness or tingling of the upper limb, and/or full-thickness tear of the rotator cuff.

Where this trial is running

Giza

• Faculty of Physical Therapy, Cairo University — Giza, Egypt (Recruiting)

Study contacts

• Study coordinator: Sara M Meselhy, Demonstrator

Conditions Subacromial Impingement Syndrome; subacromial impingement syndrome; Virtual reality; Mulligan mobilization; shoulder function; shoulder posture