<p>This study aimed to evaluate the immediate effects of reciprocal sensation in virtual reality (VR) games on shoulder function, mood state, and simulator sickness in patients with shoulder periarthritis. A crossover trial was conducted with 29 patients aged &gt; 40 years. Participants performed table-reaching exercises under three conditions: no VR (NO-VR condition), VR with gamification (Gamification condition), and VR with gamification and reciprocal sensation (Communication condition). Outcomes were assessed using the Japanese Orthopaedic Association (JOA) score for shoulder function, the Japanese version of the Profile of Mood States 2nd Edition (POMS2) for mood states, and the Simulator Sickness Questionnaire (SSQ) for simulator sickness. No significant differences in shoulder function JOA scores were observed between the three conditions. However, the Communication condition demonstrated superior maintenance of positive mood states, including the vigor-activity of POMS2, compared with the NO-VR condition. Additionally, the symptoms of simulator sickness, particularly eye strain, were significantly reduced in the Communication condition compared to the Gamification condition. Reciprocal sensations in VR games enhance mood and reduce simulator sickness, thereby providing a comfortable and engaging rehabilitation environment. These findings highlight the advantages of incorporating reciprocal sensation into VR-based therapy for patients with shoulder periarthritis.</p>