Physiotherapist beliefs and perspectives on virtual reality–supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol

Abstract

Shoulder pain accounts for a large proportion of musculoskeletal disorders and years lived with disability. Musculoskeletal shoulder pain is challenging to manage and while research evidence suggests that exercise should be a cornerstone of shoulder pain rehabilitation, the exact type and dosage of exercise is unclear. Adherence is a barrier to successful outcomes with exercise-based management of musculoskeletal pain, especially for those with co-morbidities, high pain levels and reported boredom associated with competing prescribed exercise. Virtual reality (VR) may offer an effective platform for rehabilitation of musculoskeletal shoulder pain. VR has been shown to be effective for management of acute and chronic pain conditions, for delivering education around various health conditions, and for supporting rehabilitation of neurological conditions. Therefore, it is possible that VR may have a role in the delivery of exercise and education for individuals with musculoskeletal shoulder pain. VR intervention design should involve several steps and begin with establishing early acceptability from users as to the suitability of the technology in clinical practice as well as potential barriers and facilitators to using the technology successfully. This study will therefore aim to explore physiotherapists beliefs and perspectives of immersive VR as a platform for assessment and rehabilitation in patients with musculoskeletal shoulder pain. Further, this study will inform the development of a VR intervention for use in the rehabilitation of musculoskeletal shoulder pain. A series of online focus groups will be conducted with physiotherapists in Ireland using a qualitative descriptive approach to data analysis. A six-phase process of data analysis will be carried out to identify important patterns and themes within the data. The current study will be the first to explore clinician’s perspectives on the role of VR in musculoskeletal practice.

Experiences of physiotherapists considering virtual reality for shoulder rehabilitation: A focus group study

“…These findings align with a study conducted by Brady et al 32 which involved focus group interviews with Irish physiotherapists exploring their beliefs and perspectives on immersive VR as a rehabilitation platform for patients with shoulder pain. Similar to the Dutch physiotherapists in the current study, Irish clinicians expressed positive sentiments regarding the use of VR in treating shoulder pain patients and had comparable thoughts on patient selection, such as targeting those with chronic shoulder pain and kinesiophobia.…”

“…An important strength of this study is the similarity to the study design conducted by Brady et al 32 Results may therefore be compared and stronger conclusions may be drawn regarding the experiences and perceptions of physiotherapists on the use of VR in physiotherapy care. Another strength is that participants were experienced in the rehabilitation of individuals with shoulder pain.…”

“…Only limited information pertaining to acceptability of VR technology is available, and as such it is timely to explore physiotherapists experiences and perspectives of immersive VR as an intervention tool for the treatment of patients with musculoskeletal shoulder pain. One qualitative study was conducted in Ireland in 2021–2022 32 reporting that Irish physiotherapists consider VR as an appropriate tool for enhancing movement and physical activity in patients with shoulder pain. However, concerns were expressed about safety and practicalities for clinical use.…”

Immersive virtual reality for shoulder rehabilitation: evaluation of a physical therapy program executed with oculus quest 2

“…VR is a computer-generated 3D environment that makes highly interactive experiences possible, significantly impacting patient entertainment, education, and communications [ 1 ]. VR has been increasingly used in various medical fields, including mental health therapy [ 4 – 6 ], neurological rehabilitation [ 7 – 9 ], low back pain [ 10 , 11 ], and shoulder disorders [ 12 – 14 ]. Moreover, VR has been applied for educational purposes simulating surgical procedures in both orthopedic and neurological fields [ 15 – 17 ].…”

Rapid review of virtual rehab in musculoskeletal injuries in athletes

“…Physical activity is advocated in the sense of extensive fitness, for the majority of people, a non surgical administration that includes physical treatment is advised like the beginning point of treatment. Considering the musculoskeletal pain, virtual rehabilitation is best accepted for its acceptance in action and amusement possess flatter an essential complementary conducting device in several zones of health care, such as pain management, musculoskeletal conditions, neural rehab, as well as in mental illness (1). This type of problems play an important role in sports performance as well as athletes health (2).…”