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RecruitingNCT07369934Updated Jan 27, 2026

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

An interventional study of Virtual Reality and Mulligan mobilization in Subacromial Impingement Syndrome, sponsored by Cairo University. Recruiting at 1 site in Egypt. Open to participants aged 30 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-01-27.

Sponsored by Cairo University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by May 2026, 5 months ago, but the record still lists the study as recruiting.
  • Started Dec 2025; still recruiting 9 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
74
Allocation
Randomized
Ages
30 Years to 50 Years
Sex
All
01

Study 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.

02

Conditions studied

  • Subacromial Impingement Syndrome

Keywords

  • subacromial impingement syndrome
  • Virtual reality
  • Mulligan mobilization
  • shoulder function
  • shoulder posture
03

In context

Shoulder Impingement Syndrome

304 studies on the registry are indexed under Shoulder Impingement Syndrome; 55 are open to participants now.

This study's planned enrollment of 74 is above the median of 54 across 261 interventional studies indexed under Shoulder Impingement Syndrome.

Browse Shoulder Impingement Syndrome studies →

Lead sponsor

Cairo University is the lead sponsor of 4,780 studies on the registry; 1,427 are open to participants now.

Of its 36 completed or terminated interventional studies of FDA-regulated products, 5 (14%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

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.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
74 participants (estimated)

Study arms

  • Active comparator
    Virtual reality group

    Other: Virtual Reality

  • Active comparator
    Mulligan mobilization group

    Other: Mulligan mobilization

Interventions

  • OtherVirtual Reality

    Fully immersive virtual reality mounted headset will be used

  • OtherMulligan mobilization

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

06

What researchers measure

Primary outcomes

  1. Pain intensity during shoulder elevation

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

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

  2. Shoulder function

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

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

  3. Shoulder flexion range of motion

    The Clinometer Application will be used to measure it.

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

  4. Shoulder abduction range of motion

    The Clinometer Application will be used to measure it.

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

  5. shoulder posture

    Sagittal Shoulder Angle will be used to measure the shoulder posture

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

Secondary outcomes

  1. Patients' enjoyment

    A 7-point likert scale will be used to the evaluate the level of the patients' enjoyment at the end of the last session.

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

  2. patients' adherence to treatment sessions

    patients' numbers of attended sessions will be calculated at the end of 1 month of treatment.

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

07

Study locations

1 of 1 sites recruiting
  • Faculty of Physical Therapy, Cairo University
    Giza, Egypt
    • Afaf M Tahoon, lecturer · Contact · Afaf_tahoon@cu.edu.eg · +01015401783
    • Sara M Meselhy, Demostrator · Principal investigator
    Recruiting
08

References and documents

Publications

  • Steiner B, Elgert L, Saalfeld B, Wolf KH. Gamification in Rehabilitation of Patients With Musculoskeletal Diseases of the Shoulder: Scoping Review. JMIR Serious Games. 2020 Aug 25;8(3):e19914. doi: 10.2196/19914. PubMed 32840488 ↗
  • Alvarez de la Campa Crespo M, Donegan T, Amestoy-Alonso B, Just A, Combalia A, Sanchez-Vives MV. Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: an experimental study. J Orthop Surg Res. 2023 Sep 26;18(1):729. doi: 10.1186/s13018-023-04158-w. PubMed 37752613 ↗
  • Lin HT, Li YI, Hu WP, Huang CC, Du YC. A Scoping Review of The Efficacy of Virtual Reality and Exergaming on Patients of Musculoskeletal System Disorder. J Clin Med. 2019 Jun 4;8(6):791. doi: 10.3390/jcm8060791. PubMed 31167435 ↗
  • Hoyek N, Di Rienzo F, Collet C, Hoyek F, Guillot A. The therapeutic role of motor imagery on the functional rehabilitation of a stage II shoulder impingement syndrome. Disabil Rehabil. 2014;36(13):1113-9. doi: 10.3109/09638288.2013.833309. Epub 2014 Feb 28. PubMed 24575717 ↗
  • Consigliere P, Haddo O, Levy O, Sforza G. Subacromial impingement syndrome: management challenges. Orthop Res Rev. 2018 Oct 23;10:83-91. doi: 10.2147/ORR.S157864. eCollection 2018. PubMed 30774463 ↗
  • 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
  • Chaplin E, Karatzios C, Benaim C. Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review. Healthcare (Basel). 2023 Dec 15;11(24):3178. doi: 10.3390/healthcare11243178. PubMed 38132067 ↗
  • Ozlu A, Ustundag S, Bulut Ozkaya D, Menekseoglu AK. Effect of Exergame on Pain, Function, and Quality of Life in Shoulder Impingement Syndrome: A Prospective Randomized Controlled Study. Games Health J. 2024 Apr;13(2):109-119. doi: 10.1089/g4h.2023.0108. Epub 2024 Feb 23. PubMed 38394299 ↗
  • Gumaa M, Rehan Youssef A. Is Virtual Reality Effective in Orthopedic Rehabilitation? A Systematic Review and Meta-Analysis. Phys Ther. 2019 Oct 28;99(10):1304-1325. doi: 10.1093/ptj/pzz093. PubMed 31343702 ↗
  • Dias D, Neto MG, Sales SDSR, Cavalcante BDS, Torrierri P Jr, Roever L, Araujo RPC. 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. J Clin Med. 2023 Nov 29;12(23):7416. doi: 10.3390/jcm12237416. PubMed 38068468 ↗
  • Delgado-Gil JA, Prado-Robles E, Rodrigues-de-Souza DP, Cleland JA, Fernandez-de-las-Penas C, Alburquerque-Sendin F. Effects of mobilization with movement on pain and range of motion in patients with unilateral shoulder impingement syndrome: a randomized controlled trial. J Manipulative Physiol Ther. 2015 May;38(4):245-52. doi: 10.1016/j.jmpt.2014.12.008. Epub 2015 Apr 30. PubMed 25936465 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07369934
Lead sponsor
Cairo University
Responsible party
Sara Mohsen Sayed Meselhy (Demonstrator at the Faculty of Physical Therapy, Cairo University, Cairo University) — Principal investigator
First posted
Jan 27, 2026
Start date
Dec 13, 2025
Primary completion
May 2026 (estimated)
Completion
May 2026 (estimated)
Last update
Jan 27, 2026

Study contacts

Sara M Meselhy, Demonstrator
Contact
sara.mohsen@cu.edu.eg
+01222518092
Afaf M Tahoon, lecturer
Contact
Afaf_tahoon@cu.edu.eg
+01015401783
Enas Fawzy Youssed, Professor Doctor
study chair · Cairo University
Afaf M Tahoon, lecturer
study director · Cairo University
Mohamed A Kotb, Assistant professor
study director · Cairo University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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