Effectiveness of proprioceptive neuromuscular facilitation exercise with virtual reality motion capture gaming system and concurrent feedback on early shoulder muscle activation in healthy individuals.

This study explores the effect of proprioceptive neuromuscular facilitation (PNF) exercises combined with a virtual reality (VR) motion capture system and concurrent feedback (CF) on early shoulder muscle activation in healthy individuals. Thirty healthy participants sequentially performed three PNF diagonal 2 shoulder exercises: PNF alone, PNF with VR (PNF+VR), and PNF with VR and CF (PNF+VR+CF), with the latter two exercises presented in randomized order. Using wireless surface electromyography and 3-dimensonal (3D) inertial measurement units, the activation of the upper trapezius (UT), lower trapezius (LT), infraspinatus (INF), and serratus anterior (SA) muscles, as well as shoulder flexion, abduction, and external rotation range of motion, were recorded during three exercises. INF and LT muscles were activated earlier in abduction and flexion during PNF+VR and PNF+VR+CF exercises than in PNF alone (P<0.05). These muscles were also activated during the early external rotation phase during PNF alone (P<0.05). No statistically significant differences were observed in UT and SA muscle activation among PNF alone, PNF+VR, and PNF+VR+CF exercises (P>0.05). Integrating VR gaming elements and CF into PNF shoulder exercises may promote early muscle activation, offering a promising approach for advanced rehabilitation strategies that can potentially improve patient outcomes. VR motion capture systems have the potential to transform traditional therapeutic approaches by increasing enjoyment and engagement, which can, in turn, enhance patient motivation and adherence.