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.
Highlights
Musculoskeletal disorders are a major cause of years lived with disability[1] and shoulder conditions are between the second and fourth most common musculoskeletal disorder with a lifetime prevalence of up to 70%2,3
A non-surgical management approach including exercise therapy is recommended as first line management for the majority of individuals with musculoskeletal shoulder pain, the best type or intensity of exercise is unknown
Study aims This study aims to explore physiotherapist beliefs and perspectives of immersive Virtual reality (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
Summary
Musculoskeletal disorders are a major cause of years lived with disability[1] and shoulder conditions are between the second and fourth most common musculoskeletal disorder with a lifetime prevalence of up to 70%2,3. Paloneva et al.[4] found that in a population of individuals consulting primary healthcare for shoulder disorders in Finland, the average cost of treatment per patient per year was €543, with surgical procedures accounting for the highest overall cost. Of those who suffer with shoulder pain, approximately 70% continue to experience symptoms one-year post onset[4,5,6,7]. 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? 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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