Radar degli Studi Clinici

Pain intensity measured by the Visual Analog Scale (VAS)

The VAS assesses perceived shoulder pain intensity on a 10-cm line from "no pain" to "worst pain imaginable.

Baseline and at the end of the 6-week intervention period

Shoulder Function (Shoulder Pain and Disability Index - SPADI)

Shoulder pain and disability will be assessed with the SPADI, which evaluates pain and functional limitation on a 0-100 scale, where higher scores indicate greater impairment.

Baseline and at the end of the 6-week intervention period

Shoulder Range of Motion (ROM)

Shoulder joint mobility (flexion, extension, abduction, adduction, internal and external rotation) will be measured in degrees using a goniometer to evaluate changes in movement capacity.

Baseline and at the end of the 6-week intervention period

Pain Catastrophizing (Pain Catastrophizing Scale - PCS)

Catastrophic thinking related to pain will be assessed using the PCS, which measures rumination, magnification, and helplessness. Total scores range from 0 to 52, with higher scores indicating greater levels of pain catastrophizing.

Baseline and at the end of the 6-week intervention period

Sleep Quality (Pittsburgh Sleep Quality Index - PSQI)

The PSQI assesses sleep quality over the past month across seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Component scores (0-3) are summed to yield a global score (0-21), with higher scores indicating poorer sleep quality (commonly, \>5 suggests poor sleep).

Baseline and at the end of the 6-week intervention period

Digit Span Test

The Digit Span Test (DST) will be used to assess attention, short-term memory, and processing speed. It consists of two parts: Digit Span Forward (DSF) and Digit Span Backward (DSB). The total score ranges from 0 to 17 (maximum DSF = 9, DSB = 8). Higher scores indicate better verbal attention and short-term memory performance.

Baseline and at the end of the 6-week intervention period

Wisconsin Card Sorting Test

Wisconsin Card Sorting Test (WCST) will be used to assess executive functions, including cognitive flexibility, abstract reasoning, and problem-solving ability. The primary outcome measures will include total errors, perseverative errors, and non-perseverative errors. Scores range from 0 to 128, with fewer errors indicating better executive functioning.

Baseline and at the end of the 6-week intervention period

Benton Visual Retention Test

Benton Visual Retention Test (BVRT) will be used to assess short-term visual memory, visual perception, and visuoconstructive abilities. The version used in this study will be Form F, which will include 15 stimulus cards and 15 corresponding multiple-choice response cards. Scores will be calculated as the number of correct responses, with a possible range of 0 to 15. Higher scores will indicate better visual memory performance.

Baseline and at the end of the 6-week intervention period

Virtual Reality Discomfort Questionnaire

Virtual Reality Discomfort Questionnaire includes symptoms such as fatigue, eyestrain, headache, and dizziness. Each item is rated on a 4-point Likert-type scale ranging from 0 (never) to 3 (very often). The total score is obtained by summing all item scores and then converting it into a percentage for interpretation. Higher scores indicate a greater level of discomfort associated with virtual reality use.

At the end of the first Virtual Reality session

Virtual Reality Satisfaction Questionnaire

Virtual Reality Satisfaction Questionnaire will be used to provide descriptive data to understand the contribution of the virtual reality experience to the therapeutic process and patient comfort. The questionnaire consists of a total of 10 items under four subdimensions: ease of use, visual/auditory experience, engagement/interest, and overall satisfaction. Each item will be rated on a 4-point Likert-type scale ranging from 0 (never) to 3 (very often). The total score will be obtained by summing all item scores and converting the result into a percentage for interpretation. Higher scores will indicate greater patient satisfaction with the virtual reality experience.

At the end of the first Virtual Reality session