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

Niamh Brady,Karen Mccreesh,Beate Dejaco,Jeremy Lewis,Joseph G Mcveigh

doi:10.12688/hrbopenres.13239.2

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. Virtual Reality 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.

Highlights

Overall, many positive aspects of Virtual reality (VR) are mentioned, and often references to non-musculoskeletaI literature is provided
Study aims This study aims to explore physiotherapists’ beliefs and perspectives of immersive VR as a platform for assessment and rehabilitation in patients with musculoskeletal shoulder pain and to identify potential barriers and facilitators to using VR in a musculoskeletal setting
It is anticipated that recruitment of participants and running of focus groups will occur concurrently between the months of March

Summary

Introduction

Many positive aspects of VR are mentioned, and often references to non-musculoskeletaI literature is provided. If references from other patient populations are used, I believe the authors might want to be more prudent on some occasions. For example: Paragraph 4: The authors state: ‘VR has been proposed as a more practical and attractive option than exposure therapy in vivo.’. Is this true for people with musculoskeletal pain who have movement-related fear? We probably need to be able to track the movement patterns of patients and integrate this into the VR environment. This requires using movement sensors, camera systems,. I am not sure whether, at the moment, VR is more practical for exposure therapy for movement-related fear (e.g. is it practical for home exercises?)

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