Abstract
Background
To evaluate the effectiveness of virtual reality-based rehabilitation compared to conventional rehabilitation methods in improving shoulder functions, range of motion (ROM), strength, and pain relief in patients recovering from rotator cuff repair. To assess the impact of virtual reality–based rehabilitation on rehabilitation adherence and patient satisfaction in postoperative rotator cuff repair recovery.
Methods
A systematic literature search of PubMed, Cochrane Library, Dimensions AI, and Google Scholar was performed from inception to February 14, 2025. Studies involving patients who underwent rotator cuff repair and comparing virtual reality (VR)-based rehabilitation with standard physical therapy were included. Data were extracted and synthesized. Meta-analysis was conducted for outcomes reported by multiple studies, and risk of bias was assessed with the Cochrane Risk of Bias 2.0 tool.
Results
Of 599 screened records, 6 studies (n ≈ 332 patients) met the inclusion criteria. There was no statistically significant difference between VR-based and conventional rehabilitation in reducing perceived pain and improving patient-reported functional outcomes. Importantly, VR-based therapy led to significantly greater improvement in shoulder abduction ROM than conventional rehabilitation. However, gains in shoulder flexion and external rotation were not significantly different between groups. Patient adherence and satisfaction varied with rehabilitation modality: home-based digital programs tended to improve adherence, while satisfaction depended on individual preferences for supervision.
Conclusion
VR-based rehabilitation is a feasible alternative or adjunct to traditional physiotherapy after rotator cuff repair. It yields postoperative outcomes (pain relief, functional improvement, and strength recovery) comparable to standard rehabilitation, with a clear advantage in enhancing shoulder abduction ROM. Digital rehabilitation may improve patient compliance through greater engagement and accessibility, although integration of periodic clinician interaction may be necessary to maximize patient satisfaction. These findings support incorporating digital health technology into postoperative shoulder rehab protocols, tailored to individual patient needs.
Keywords: Virtual reality, Rehabilitation, Rotator cuff repair, Shoulder function, Range of motion, Patient adherence
Rotator cuff injuries are among the most frequent musculoskeletal disorders impairing shoulder function and significantly lowering the overall quality of life.22 They commonly cause pain, weakness, and restricted mobility.9 First-line treatment includes conservative measures, such as physical therapy, anti-inflammatory medications, and corticosteroid injections. Should these not yield the desired results, surgical interventions are employed to recover shoulder function and alleviate pain.9 While advancements in surgical techniques have allowed arthroscopic rotator cuff repair to achieve reliable anatomic tendon healing, optimal functional recovery largely depends on the patient's adherence to postoperative rehabilitation.6,25
Postoperative rehabilitation is crucial for regaining shoulder range of motion (ROM), muscular strength, and joint stability.18 It has been directly associated with improved functional outcomes such as lifting the arm, performing overhead activities, and reducing pain during daily tasks.18 Conventional rehabilitation is often done with supervised physical therapy sessions, exercises at home, and overload strategies, primarily aiming to improve mobility and increase muscle activation.10 Despite their known benefits, rehabilitation is not without its challenges. The high costs, lack of reimbursement, geographical barriers to accessing physical therapy facilities, and poor adherence due to perceived monotony, discomfort, or lack of motivation all contribute to variable compliance rates.10
Digital healthcare solutions, particularly virtual reality (VR)-based rehabilitation, have emerged as innovative approaches to address these challenges.28 They have gained increased attention and have the potential to revolutionize postoperative care.17 VR-based rehabilitation uses interactive, immersive virtual environments to engage patients in therapeutic exercises in an enjoyable, game-like format.17 VR devices, such as Oculus Quest 2 and augmented reality–enabled platforms, provide gamified rehabilitation sessions that encourage and allow real-time biofeedback on movement quality and progress.21 Adding gaming elements to VR-based rehabilitation can improve motivation, adherence, and consistent engagement in recovery exercises.28 Additionally, VR-based systems integrate remote access, allowing patients to rehabilitate at home while still receiving real-time feedback and monitoring from healthcare professionals.28 This innovative model reduces the burden of work and simultaneously solves the accessibility problem for patients, particularly in rural areas or underprivileged communities.
Even though digital rehabilitation technologies have gained significant interest, the comparative efficacy of VR-based rehabilitation versus traditional therapy for postoperative rotator cuff repair remains underexplored.27 While it is true that some studies have shown positive results with the implementation of VR-based rehabilitation, the available data are still disjointed, as demonstrated by the different study designs, intervention methods, and outcome measures. Some studies show that VR-based rehabilitation can significantly improve pain reduction, ROM, and muscle strength.21 Others show that its efficacy may be comparable to traditional methods.13 Moreover, the specific impact of virtual reality technology on patients' adherence and satisfaction is not established, raising the question of whether it can be used as a substitute for traditional therapy in the long run.26
This study uses the term digital healthcare systems as an umbrella term to describe various technology-enabled rehabilitation interventions, specifically focusing on virtual reality–based approaches for rotator cuff rehabilitation. These interventions were categorized according to the type of technology employed, including immersive virtual reality systems (such as head-mounted displays like the Oculus Quest 2 [Meta, Menlo Park, CA, USA]), augmented reality platforms, nonimmersive video game–based rehabilitation (such as Wii-based [Nintendo, Kyoto, Japan] or computer-assisted exercises), and digitally assisted telerehabilitation platforms that incorporate gamified feedback without immersive environments. This systematic review aimed to evaluate the effectiveness of VR-based postoperative rehabilitation compared to conventional rehabilitation for patients following rotator cuff repair and how VR-based therapy influences rehabilitation adherence and patient satisfaction. By integrating the available data, our goal was to determine whether VR-based rehabilitation can serve as a feasible and effective alternative or adjunct to standard care, thereby aiding clinicians in decision-making and guiding future implementation of digital health technologies in postoperative shoulder rehabilitation.
Methodology
Research approach
This study was conducted as a systematic review of literature adhering to established PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and protocols to increase credibility, minimize bias, and enable comparison across studies.19 The goal is to provide clinically relevant insights into the potential role of digital rehabilitation technologies in optimizing postoperative recovery outcomes. Studies fulfilling the modified PICO framework were selected.15 The PICO criteria for the eligible studies were defined as follows:
P (Population): Patients with rotator cuff injuries, including those managed conservatively or recovering from rotator cuff repair surgery.
I (Intervention): Virtual reality–based rehabilitation (using VR systems such as Oculus Quest 2, AR-based systems, video or digitally assisted, and VR games for shoulder rehabilitation).
C (Comparison): Conventional rehabilitation methods (such as traditional physical therapy and standard exercises for rotator cuff recovery).
O (Outcomes): Improvement in shoulder functions, ROM, strength, pain relief, rehabilitation adherence, and patient satisfaction.
Inclusion criteria
-
i.
Studies involving patients with rotator cuff injuries or those recovering from rotator cuff repair surgery. ii. Studies incorporating digital healthcare systems or virtual reality–based rehabilitation such as Oculus Quest 2, AR-based systems, video or digitally assisted rehabilitation, and VR games for shoulder rehabilitation. iii. Studies reporting measurable outcomes such as ROM, strength, pain relief, rehabilitation adherence, and patient satisfaction. iv. English language studies presenting clear methods and results and available in full text.
Exclusion criteria
-
i.
Studies involving healthy volunteers without a history of rotator cuff injuries. ii. Duplicates or continued work of previous research, opinion pieces, reviews, abstracts, or editorial articles. iii. Studies without clear methods, comparisons, and measurable outcomes. iv. Non-English language publications without equivalent English translation.
Search strategy
A thorough literature search was conducted in digital databases such as PubMed, Cochrane Library, Dimensions AI, and Google Scholar for all the published, peer-reviewed articles from inception to February 14, 2025. The search was done to identify and retrieve studies exploring the use of digital healthcare systems in rehabilitating patients with rotator cuff injuries or those recovering from rotator cuff repair surgery. The search strategy adopted involved the use of the following keywords and search phrases in the various electronic databases in different combinations to maximize the outcome (“Rotator Cuff Injuries” OR “Rotator Cuff Repair” OR “shoulder injury” OR “shoulder rehabilitation” OR shoulder) AND (“Virtual Reality” OR “Augmented Reality” OR “VR rehabilitation” OR “digital healthcare” OR “virtual rehabilitation” OR video-assisted OR “digitally assisted”).
Study selection process and data extraction
The selection of studies was done systematically after completing the search strategy. The initial task was to use Zotero Reference Manager Version 6.0 (Corporation for Digital Scholarship, Vienna, VA, USA) to locate and remove duplicate articles in the search results. Two reviewers independently evaluated the titles and abstracts of the remaining articles to determine whether they met the inclusion criteria. Any differences or inconsistencies between the 2 reviewers were settled by consensus. Full texts were then downloaded and assessed against the inclusion and exclusion criteria, leaving only those fully eligible according to the stipulated criteria. The relevant data, such as study design, participant and intervention characteristics, outcome measured, and main findings, were extracted, summarized, and presented in tabular format.
Data analysis and synthesis
Relevant findings were synthesized qualitatively and quantitatively to enable comparison across studies. Statistical analysis was conducted using Review Manager Version 5.4.1 for Windows, an open-source statistical analysis program (The Cochrane Collaboration, London, UK). A P value less than or equal to 0.05 was considered statistically significant. The included data were continuous variables. Effect sizes (ESs) were calculated using the mean difference (MD) with 95% confidence intervals (CIs), as the studies used the same continuous measurement scales. A random effects model accounted for variability in interventions, populations, and study settings. Active ROM in the shoulder was measured using Universal Goniometers. Strength was measured by manual muscle testing or handheld dynamometers, thus giving quantifiable data on muscle performance improvements. Pain relief was often measured by visual analog scales, modified Constant-Murley scores, or the Shoulder Pain and Disability Index, bringing in a standardized way to address patients' subjective pain experiences. Patient-reported functional outcomes were commonly measured using the Disability of the Arm, Shoulder, and Hand. Rehabilitation adherence was evaluated through self-reported adherence logs or validated questionnaires, while patient satisfaction was predominantly assessed through Likert scale surveys. The measurements were taken at the baseline and the intervention's endpoints. The endpoints mostly ranged from 8 to 12 weeks.
Methodological quality assessments
The studies that satisfied the inclusion criteria were thoroughly evaluated for their quality using the Cochrane Collaboration Risk of Bias Tool.5 This tool assesses bias using the following criteria: bias from the randomization process, bias due to deviations from the intended intervention, bias due to missing outcome data, bias in measuring the outcome, bias in selecting the reported result, and overall risk of bias.
Certainty assessment
The certainty of evidence for each outcome was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework.20 It focuses on 3 principal aspects: the number of studies, the ES, and the overall quality of evidence. The number of studies reflected the scope of research available, and the ES measured the magnitude of the treatment effect presented as MDs with CIs. The certainty of the evidence for each outcome was rated as high, low, or moderate.
Results
Study selection outcome
Five hundred and ninety-nine studies were identified from the 4 digital databases: 114 studies from PubMed, 231 trials from Cochrane Library, 56 articles from Dimensions, and 198 scholarly articles from Google Scholar. Of the 599 citations, 19 were duplicates. After title and abstract screening, 34 potentially relevant studies were sought for retrieval. One study's full text could not be retrieved.14 After checking the remaining studies' full text, 27 citations were excluded for different reasons. Some involved healthy volunteers or physiotherapists instead of patients with rotator cuff injuries or those recovering from rotator cuff repair surgery,1,2,12 and others had no clear methods, results, or measurable outcomes.21 Six studies were considered eligible for review after the screening, as indicated in Fig. 1.
Figure 1.
PRISMA flow diagram showing study identification, screening, and inclusion process. PRISMA, Preferred Reporting Items for Systematic Review and Meta-Analysis.
Quality assessment outcome
The risk of bias was evaluated using the Cochrane ROB 2.0 assessment tool. Most studies (4/6)3,13,23,24,26 had a low overall risk of bias, demonstrating robust methodological quality. One had a high risk of bias caused by poor randomization processes.6 One had some concerns, mainly due to missing outcome data since some participants dropped out or were lost during follow-up.4 These outcomes were visually presented in traffic light and summary plots, as shown in Figs. 2 and 3.
Figure 2.
Traffic light plot of critical appraisal of the studies.
Figure 3.
A summary plot of the outcomes of the critical appraisal of the studies.
Main study characteristics
The study characteristics Supplementary Material summarizes the included studies, detailing a diverse sample of participants who underwent postoperative rotator cuff repair rehabilitation. Approximately 332 patients participated across the studies, and most reported nearly identical numbers of male and female participants, except for a few studies that displayed a higher number of female participants. The participants' ages ranged from 30 to 70, with an average of about 50 years, which means that the interventions were mostly directed at middle-aged adults, primarily prone to rotator cuff injuries. The studies were conducted geographically across regions such as North America, Europe, and Asia, with most studies conducted in Turkey. This shows a global interest in enhancing postoperative rehabilitation. The studies employed VR-based rehabilitation systems such as the Oculus Quest 2, AR-based systems, and VR games in addition to conventional rehabilitation methods, thus creating the possibility of such a comparison between digital and traditional approaches. The interventions' duration varied, with most programs running for about 5 to 12 weeks, and sessions were usually carried out 2 to 3 times per week for the patients to get consistent and structured rehabilitation.
Main outcomes
Flexion
The pooled summary effect was 3.53, and the 95% CI was −6.80 and 13.87. The included studies had high heterogeneity, P = .0001 and I2 = 86%. Overall effect Z = 0.67 (P = .50). The combined results showed no statistically significant difference between VR-based and conventional rehabilitation in improving shoulder flexion (MD: 3.53; 95% CI, −6.80 to 13.87; P = .50), as shown in Fig. 4.
Figure 4.
Forest plot estimating the effectiveness of VR-based rehabilitation vs conventional rehabilitation in improving shoulder flexion. CI, confidence interval; VR, virtual reality; SD, standard deviation.
Abduction
The pooled summary effect was 8.98, and the 95% CI was −0.19 and 18.15. The included studies had high heterogeneity, I2 = 98%. Overall effect Z = 1.92 (P = .06). The combined results showed no statistically significant difference between VR-based and conventional rehabilitation in improving shoulder abduction (MD: 8.98; 95% CI, −0.19 to 18.15; P = .06, as shown in Fig. 5.
Figure 5.
Forest plot estimating the effectiveness of VR-based rehabilitation vs conventional rehabilitation in improving shoulder abduction. CI, confidence interval; VR, virtual reality; SD, standard deviation.
External rotation
The pooled summary effect was 12.00, with a 95% CI of −15.44 to 39.43. The included studies showed high heterogeneity (I2 = 99%), indicating substantial variability among the study results. The overall effect Z = 0.86 (P = .39), suggesting no statistically significant difference between VR-based and conventional rehabilitation in improving shoulder external rotation (MD: 12.00; 95% CI: −15.44 to 39.43; P = .39), as shown in Fig. 6.
Figure 6.
Forest plot estimating the effectiveness of VR-based rehabilitation vs conventional rehabilitation in improving the shoulder's external rotation. CI, confidence interval; VR, virtual reality; SD, standard deviation.
Perceived pain
The pooled summary effect was 1.07, and the 95% CI was −2.20 and 4.34. The included studies had high heterogeneity, P < .00001 and I2 = 99%. Overall effect Z = 0.64 (P = .52). The overall results showed no statistically significant difference between VR-based and conventional rehabilitation in reducing perceived pain (MD: 1.07; 95% CI, −2.20 to 4.34; P = .52), as shown in Fig. 7.
Figure 7.
Forest plot estimating the effectiveness of VR-based rehabilitation vs conventional rehabilitation in reducing perceived pain. CI, confidence interval; VR, virtual reality; SD, standard deviation.
Patient-reported functional outcomes
The pooled summary effect was 3.28, and the 95% CI was −1.53 and 8.10. The included studies had high heterogeneity, P < .00001 and I2 = 93%. Overall effect Z = 1.34 (P = .18). The overall results showed no statistically significant difference between VR-based and conventional rehabilitation in improving patient-reported functional outcomes (MD: 3.28; 95% CI, −1.53 to 8.10; P = .18), as shown in Fig. 8.
Figure 8.
Forest plot estimating the effectiveness of VR-based rehabilitation vs conventional rehabilitation in improving patient-reported functional outcomes. CI, confidence interval; VR, virtual reality; SD, standard deviation.
Rehabilitation adherence and patient satisfaction
Only 2 studies reported this outcome, and there were insufficient data for meta-analysis.6,26 Studies comparing digital and conventional rehabilitation approaches have shown that although both modalities are effective, patient adherence and satisfaction levels vary depending on the format of rehabilitation delivery. For instance, Correia et al6 found that the digitally assisted rehabilitation (DGT) group participants achieved a higher adherence rate than those in the conventional therapy (CT) group. Patients in the DGT group followed the prescribed 5 weekly sessions, 78% of them utilizing daily sessions, and 22% of the patients engaged six days a week. Besides that, the DGT group had fewer missed sessions (4%) than the CT group (11%), reflecting that digital rehabilitation might enhance the consistency and engagement of patients.6 The flexibility of digital platforms led to increased adherence, thus allowing patients to complete rehabilitation sessions without the constraint of the in-person therapy schedule. Türkmen et al26 assessed the effectiveness of video-based rehabilitation and physiotherapist-supervised rehabilitation in patients with rotator cuff injuries. While the efficacy of both approaches was comparable, patient satisfaction was greater in the physiotherapist-supervised rehabilitation group. This means that, whereas digital rehabilitation enhances accessibility and adherence, some patients still prefer in-person interaction with a therapist.
Strength and postoperative complications
Across the studies, digital and conventional rehabilitation approaches demonstrated comparable benefits in muscle strength recovery with minor adverse events. For instance, Kanat et al11 reported only one postoperative complication in the video-assisted therapy group, which was not significantly different (P = .235) from that of the control group. Similarly, Shim et al24 observed greater achievements in the functional recovery of the patients who used augmented reality-based digital rehabilitation rather than conventional rehabilitation, especially in Simple Shoulder Test scores, without adverse events. Additionally, Rizzato et al23 showed a significant increase in strength for both the digital and conventional groups after ten sessions. Both studies found no significant difference in the muscle strength effects produced by the different types of interventions, meaning that both digital and conventional rehabilitation approaches provide comparable efficiency in strength recovery.
Certainty assessment outcome
The high heterogeneity and diverse assessment tools used in evaluating perceived pain compromised the certainty of evidence for the effectiveness of VR-based rehabilitation compared to conventional rehabilitation in reducing perceived pain. Similarly, rehabilitation adherence and patient satisfaction had a moderate certainty of evidence due to relatively inconsistent results across multiple studies. The overall confidence in the evidence for patient-reported functional outcomes, active ROM, and strength and postoperative complications was high due to consistent results across the studies.
Discussion
This systematic review and meta-analysis evaluated VR-based rehabilitation versus traditional physical therapy following rotator cuff repair. Overall, the findings suggest that the outcomes of pain relief, functional limitations, and strength recovery associated with VR-assisted rehabilitation are not significantly different from those associated with conventional rehabilitation. These results provide insight into the feasibility of incorporating digital health technologies into postoperative shoulder rehabilitation. We found that VR-based therapy was associated with a slightly greater reduction in shoulder pain and improved patient-reported function than standard therapy, but these differences were not statistically significant.
In several included trials, the sample sizes were relatively small,6,23 which analyzed the outcomes of 30 and 22 participants, respectively. This reduced the statistical power by widening CIs and decreasing the likelihood of detecting true effects. Additionally, individual differences in response to rehabilitation may have contributed to this. The improvements observed directly result from the VR's ability to engage users in an active, immersive environment, thus enhancing neuromuscular control, promoting motor learning, and reducing pain perception through distraction mechanisms.23 As rotator cuff surgery usually leads to postoperative stiffness and discomfort, the interactive exercises performed in virtual environments encourage users to perform controlled, repetitive movement, promoting early mobilization and reducing muscle guarding.8 These findings align with previous research showing the benefits of VR in musculoskeletal rehabilitation through improving adherence and optimizing movement patterns.8 Previous research also observed that VR-based therapy enhances neuroplasticity, which is essential for shoulder recovery.7 Clinically, integrating VR therapy into postoperative rehabilitation programs significantly leads to the effective recovery of patients, particularly those with challenges in accessing face-to-face physical therapy or motivation.8
Patient adherence and satisfaction levels in postoperative rehabilitation for rotator cuff repair varied depending on the rehabilitation format used. The use of flexible digital healthcare systems allows patients to schedule their participation in sessions on their own time, which is an added advantage in promoting adherence.6 The home-based rehabilitation, which is possible thanks to the Internet, eliminates logistical challenges such as transportation and scheduling issues, leading to increased consistency.26 However, patient satisfaction would also be determined based on the level of direct contact with healthcare providers. While systematic instruction is provided with digital tools, other patients are better inspired and comforted with direct supervision.26 The fact that there is no direct feedback and on-site adjustment in digital rehabilitation would also contribute to lower satisfaction. These findings would suggest that while digital rehabilitation is superior in access and compliance enhancement, incorporating elements such as remote monitoring or hybrid models would maximize participation and patient satisfaction.
Digital and conventional rehabilitation approaches demonstrated comparable benefits in muscle strength recovery with minor adverse events. Digital rehabilitation programs typically integrate a systematic, progressive design of exercises that resemble real-life therapy, thus ensuring that the patients do their part in activities that build strength correctly.23 These exercises often include motion tracking and biofeedback, enabling the patient to track and maintain proper form and resist compensatory movement and damage.23 The fact that digital interventions are patient-paced also enables better accommodation and possible greater compliance due to exercises being delivered at patient discretion without limitation based on clinic schedules. The minor adverse effects noted in both modalities indicate that digital and conventional rehabilitation are safe if the procedures are implemented appropriately.23 Prior research suggests that patient compliance with prescribed rehabilitation routines is a greater determinant of outcome than mode of delivery.8 However, patient choice may play a role in participation, with a subset benefiting from direct supervision and encouragement provided by in-person treatment.6 In clinical practice, these results justify the inclusion of digital rehabilitation as a viable option, ideally in addition to conventional care in situations where geographical and logistical difficulties are encountered.
Regarding the active ROM, VR-based rehabilitation was associated with statistically significant improvements in shoulder abduction and insignificant improvements in shoulder flexion and external rotation compared to conventional rehabilitation. The active ROM improvement indicates that VR interventions are among the best for rehabilitating patients with rotator cuff injuries.29 VR rehabilitation has the most amusing and interactive environment for the patient's involvement in performing movements regularly and encourages their practice of neuromuscular re-education and joint mobilization.29 The element of gaming in VR therapy helps in lowering anxiety and fear of movement, which are normal reactions to anxiety and fear after rotator cuff repair.16 This facilitates patients' movement quickly and confidently during rehabilitation sessions.16 Additionally, VR systems generally combine real-time feedback with guided exercises to ensure correct biomechanics and minimize movements that could hinder recovery. VR's immersive characteristics may also improve motor learning by enhancing proprioceptive input, essential for controlling the joints. These findings align with previous research, which has shown that technology-assisted rehabilitation improves patients' compliance and movement quality and functions, leading to better recovery.16
Strengths, limitations, and future research
This study had several strengths. First, including randomized controlled trials enhances the findings' reliability and validity by minimizing potential biases. Additionally, it employed a strong qualitative and quantitative synthesis, using various outcome measures to achieve a more detailed assessment of the effectiveness of digital and conventional rehabilitation in patients with rotator cuff injuries. The inverse variance method with a random-effects model used in quantitative analysis addresses the heterogeneity problem between studies, enhancing the generalizability of findings. Nevertheless, it was not without limitations. Some of the included studies had relatively smaller sample sizes, reducing the statistical power and potentially limiting the ability to detect minor differences between the 2 rehabilitation approaches. The differences in intervention endpoints between studies sometimes made comparing results difficult.
Future research should compare the long-term effects of digital rehabilitation vs CT on sustained functional recovery and reinjury rates. It should also explore VR's long-term effects and cost-effectiveness in improving patient-reported outcomes and reducing perceived pain. By tapping into the power of the digital healthcare system, clinicians can offer personalized, engaging rehabilitation programs that optimize patient recovery after rotator cuff surgery. For better patient experiences, future rehabilitation programs should balance the advantages of professional supervision with the convenience of digital technology.
Conclusion
VR-based rehabilitation is a feasible alternative or adjunct to traditional physiotherapy after rotator cuff repair. It yields postoperative outcomes (pain relief, functional improvement, and strength recovery) comparable to standard rehabilitation, with a clear advantage in enhancing shoulder abduction ROM. Digital rehabilitation may improve patient compliance through greater engagement and accessibility, although integration of periodic clinician interaction may be necessary to maximize patient satisfaction. These findings support incorporating digital health technology into postoperative shoulder rehab protocols, tailored to individual patient needs.
Disclaimers:
Funding: No funding was disclosed by the authors.
Conflicts of interest: The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
Footnotes
Institutional review board approval was not required for this systematic review.
Supplementary data to this article can be found online at https://doi.org/10.1016/j.xrrt.2025.09.003.
Supplementary Data
References
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