{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:14:25Z","timestamp":1793229265763,"version":"4.5.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Games for Health Journal"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Arthroscopic rotator cuff repair (ARCR) often results in prolonged recovery and limited shoulder function. Conventional physical therapy rehabilitation programs require sustained patient engagement; however, adherence is frequently low. Game-based virtual reality (VR) offers an interactive and engaging environment that may enhance rehabilitation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the effect of a game-based VR program on the function of the upper limb in patients following ARCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A randomized controlled trial was conducted with patients who underwent ARCR. Participants were randomized into two groups: game-based VR or conventional rehabilitation. Outcomes were evaluated using the Disabilities of the Arm, Shoulder and Hand score, pain severity by the Numerical Pain Rating Scale, range of motion measures, and muscle strength testing. Assessments were performed at baseline and at 6 weeks and 12 weeks post surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Results have shown significant within-group improvements in pain, function, range of motion, and isometric muscle strength across all time points (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Between-group analysis revealed greater improvements in pain, function, flexion range, and abduction and external rotation strength in the experimental group at both time points (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Abduction range improved significantly only at 12 weeks (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), whereas external rotation range showed no significant difference between groups at either time point (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings indicate that integrating game-based VR rehabilitation provides additional benefits over conventional therapy in improving pain and upper extremity function following ARCR. These findings support the use of VR as an effective alternative to the conventional rehabilitation for postoperative rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2161783x261461654","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:59:25Z","timestamp":1785135565000},"page":"269-279","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of Game-Based Virtual Reality Rehabilitation and Its Impact on Upper Extremity Function After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-2335","authenticated-orcid":false,"given":"Ahmed M.","family":"El Melhat","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon."},{"name":"Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatem","family":"lazem","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health and Life Sciences, University of Exeter, EX1 2LP Exeter, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled A.","family":"Shalash","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries, Faculty of Physical Therapy, King Salman International University, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada M.","family":"Koura","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation Sciences, Collage of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallam Ali","family":"Sallam","sequence":"additional","affiliation":[{"name":"Basic Science Department, Faculty of Physical Therapy, Qena University, Qena, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Mohamed Fathi","family":"Elshiwi","sequence":"additional","affiliation":[{"name":"Consultant and Head of Physical Therapy Department, Saudi German Hospital, Aseer, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Mohamed Ali","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Cardiovascular\/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt."},{"name":"Department of Health Rehabilitation Sciences, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aseel","family":"El Kawam","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Musculoskeletal Disorders and Its Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimaa Abdelalim","family":"Essa","sequence":"additional","affiliation":[{"name":"Department of Basic sciences, Faculty of Physical therapy, Suez University, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758573217717103"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsm.2023.150978"},{"issue":"2","key":"e_1_3_4_4_1","first-page":"279","article-title":"Exercise rehabilitation in the non-operative management of rotator cuff tears: A review of the literature","volume":"11","author":"Edwards P","year":"2016","unstructured":"3.Edwards P, , Ebert J, , Joss B, et al. 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