Rhodiola rosea, a long-lived herbaceous plant from the Crassulaceae group, contains the active compound salidroside, recognized as an adaptogen with significant therapeutic potential for bone metabolism. Salidroside promotes osteoblast proliferation and differentiation by activating critical signaling pathways, including bone morphogenetic protein-2 and adenosine monophosphate-activated protein kinase, essential for bone formation and growth. It enhances osteogenic activity by increasing alkaline phosphatase activity and mineralization markers, while upregulating key regulatory proteins including runt-related transcription factor 2 and osterix. Additionally, salidroside facilitates angiogenesis via the hypoxia-inducible factor 1-alpha and vascular endothelial growth factor pathway, crucial for coupling bone development with vascular support. Its antioxidant properties offer protection against bone loss by reducing oxidative stress and promoting osteogenic differentiation through the nuclear factor erythroid 2-related factor 2 pathway. Salidroside has the capability to counteract the negative effects of glucocorticoids on bone cells and prevents steroid-induced osteonecrosis. Additionally, it exhibits multifaceted anti-inflammatory actions, notably through the inhibition of tumor necrosis factor-alpha and interleukin-6 expression, while enhancing the expression of interleukin-10. This publication presents a comprehensive review of the literature on the impact of salidroside on various aspects of bone tissue metabolism, emphasizing its potential role in the prevention and treatment of osteoporosis and other diseases affecting bone physiology.

Shoulder rehabilitation is prolonged, feedback-dependent, and frequently limited by adherence, particularly after surgery. Virtual reality (VR) and related immersive or semi-immersive technologies may support rehabilitation by combining motion tracking, visual feedback, graded repetition, and gamified engagement. This narrative review summarizes current evidence on VR and digitally assisted shoulder and upper-limb rehabilitation and critically evaluates the extent to which these data can inform post-arthroplasty pathways. A narrative review was performed using PubMed/MEDLINE, PubMed Central, and targeted cross-checking in Scopus, Web of Science, and the Directory of Open Access Journals up to May 2026. Search domains combined shoulder and upper-limb terms, virtual reality, augmented reality, mixed reality, extended reality, and exergaming terms, rehabilitation and telerehabilitation terms, and postoperative shoulder surgery or arthroplasty terms. Priority was given to systematic reviews, randomized or controlled studies, validation studies, feasibility studies, and clinician-perspective studies relevant to shoulder biomechanics and rehabilitation implementation. The available literature supports three main conclusions. First, consumer-grade immersive systems can provide reliable within-system shoulder motion monitoring, although absolute agreement across devices remains imperfect. Second, VR, exergaming, and digitally assisted rehabilitation have shown feasibility, high acceptability, and potential benefits for adherence, pain, range of motion, and patient-reported function in rotator cuff repair, adhesive capsulitis, subacromial impingement, and other shoulder disorders. Third, evidence directly specific to anatomic or reverse shoulder arthroplasty rehabilitation remains limited; therefore, extrapolation from rotator cuff repair, conservative shoulder disorders, and digital home-based arthroplasty rehabilitation should be made cautiously. Rehabilitation clinicians support supervised or hybrid use rather than autonomous unsupervised replacement of conventional care. VR should be interpreted as an adjunct to clinician-led rehabilitation, not as a stand-alone substitute. Its most plausible current roles are improving engagement, enabling structured repetition, supporting within-system range-of-motion monitoring, and extending supervised practice into home settings. Future studies should test procedure-specific, phase-based VR protocols for anatomic and reverse shoulder arthroplasty, with explicit attention to compensation control, safety limits, long-term outcomes, cost-effectiveness, and multidisciplinary oversight.