Effects of Virtual Reality-Assisted Pain Neuroscience Education on Chronic Nonspecific Low Back Pain

NCT ID: NCT07305597

Last Updated: 2025-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-15

Study Completion Date

2026-05-15

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Chronic nonspecific low back pain is a multifactorial condition involving not only biomechanical but also psychological and neurocognitive components, in which factors such as kinesiophobia and pain catastrophizing contribute to pain persistence and disability. Pain Neuroscience Education (PNE) aims to reconceptualize pain, reduce fear-avoidance behaviors, and improve function, particularly when combined with exercise, although traditional educational methods may be limited in explaining abstract concepts. Virtual reality (VR) offers an interactive and engaging platform that may enhance the effectiveness of PNE by facilitating cognitive restructuring and increasing motivation, with evidence of short-term benefits on pain and kinesiophobia. Integrating VR-supported PNE with core stabilization exercises may simultaneously address biomechanical and cognitive processes, thereby providing a more comprehensive rehabilitation approach. Accordingly, this study aims to examine the effects of adding VR-supported pain education to core stabilization exercises on pain, kinesiophobia, pain catastrophizing, functional status, and balance in individuals with chronic nonspecific low back pain.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Chronic nonspecific low back pain (CNSLBP) is a complex condition that cannot be explained solely by biomechanical factors and also involves psychological and neurocognitive components. Kinesiophobia, pain catastrophizing, and maladaptive pain beliefs have been shown to play a significant role in the chronification of pain and the increase in disability. Therefore, the Pain Neuroscience Education (PNE) approach, which focuses on the neurophysiology of pain, helps individuals reconceptualize pain, reduces fear-avoidance behaviors, and supports functional improvement. When applied in combination with exercise, PNE has been reported to provide additional benefits in reducing pain intensity, kinesiophobia, and catastrophizing. However, conventional educational methods may be limited in conveying abstract neurophysiological concepts.

At this point, virtual reality (VR) technology may enhance the effectiveness of pain education by providing an interactive and engaging learning environment. VR has been reported to facilitate cognitive restructuring in individuals with chronic pain and to increase motivation for participation. Moreover, VR-supported rehabilitation interventions have been shown to have short-term positive effects on pain and kinesiophobia in chronic pain conditions.

Core stabilization exercises are an effective method for improving postural control and functional stability in low back pain by regulating the activation of muscles surrounding the spine. However, purely physical approaches may be insufficient in adequately addressing the psychological dimensions of pain. Integrating VR-supported PNE into an exercise program may broaden the scope of rehabilitation by simultaneously influencing both biomechanical and cognitive processes. Therefore, this study aims to investigate the effects of adding VR-supported pain education to core stabilization exercises on pain, kinesiophobia, pain catastrophizing, functional status, and balance in individuals with CNSLBP. This holistic approach is expected to provide an innovative contribution to conventional exercise protocols and to shed light on the biopsychosocial management of chronic low back pain.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Chronic Non-Specific Low Back Pain

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

chronic non-spesific low back pain virtual reality pain neuroscience education

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized dontrolled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Core Stabilization + Classic Pain Neuroscience Education

Individuals in this group will undergo classical pain education (based on visual presentation or face-to-face instruction) along with core stabilization exercises targeting the muscles surrounding the spine. The exercises will be organized according to protocols reported in the literature as safe and effective and will include the following elements:

* Exercises that activate the transversus abdominis and multifidus muscles (e.g., abdominal bracing, bird-dog, plank, side bridge)
* Posture and spinal control exercises
* Stretching and mobilization movements (lumbar flexion/extension, hip flexor stretches)
* Each exercise will be performed in 2-3 sets of 10-15 repetitions, with the load increased according to participant tolerance.

During the application process, participants will be provided with classic educational materials (e.g., verbal explanations or informative brochures) about the physiological basis of pain, movement safety, and exercise-related pain management. Thi

Group Type EXPERIMENTAL

Core Stabilization Exercises

Intervention Type OTHER

Individuals in this group will undergo classical pain education (based on visual presentation or face-to-face instruction) along with core stabilization exercises targeting the muscles surrounding the spine. The exercises will be organized according to protocols reported in the literature as safe and effective and will include the following elements:

* Exercises that activate the transversus abdominis and multifidus muscles (e.g., abdominal bracing, bird-dog, plank, side bridge)
* Posture and spinal control exercises
* Stretching and mobilization movements (lumbar flexion/extension, hip flexor stretches)
* Each exercise will be performed in 2-3 sets of 10-15 repetitions, with the load increased according to participant tolerance.

Classic Pain Neuroscience Education

Intervention Type OTHER

During the application process, participants will be provided with traditional educational materials (e.g., verbal explanations or informational brochures) on the physiological basis of pain, movement safety, and pain management related to exercise. This training will not include virtual reality support.

Core Stabilization + Virtual Reality-Assisted Pain Neuroscience Education

Individuals in this group will receive SG-supported pain education in addition to the Group 1 protocol. Program details:

1. Initial Session (Week 1)

* 20-30 minutes of pain education modules in the SG environment
* Information on the neurophysiological basis of pain, catastrophizing, and fear-avoidance behaviors
* Reinforcement with interactive questions and short exercises
2. Weekly Reinforcement (Weeks 2-6)

* 10-15 minutes of short SG modules each week
* Integration with core exercise sessions

Group Type EXPERIMENTAL

Core Stabilization Exercises

Intervention Type OTHER

Individuals in this group will undergo classical pain education (based on visual presentation or face-to-face instruction) along with core stabilization exercises targeting the muscles surrounding the spine. The exercises will be organized according to protocols reported in the literature as safe and effective and will include the following elements:

* Exercises that activate the transversus abdominis and multifidus muscles (e.g., abdominal bracing, bird-dog, plank, side bridge)
* Posture and spinal control exercises
* Stretching and mobilization movements (lumbar flexion/extension, hip flexor stretches)
* Each exercise will be performed in 2-3 sets of 10-15 repetitions, with the load increased according to participant tolerance.

Virtual Reality-supported pain neuroscience education program

Intervention Type OTHER

Details of the Virtual Reality-supported pain neuroscience education program:

1. Introductory Session (Week 1)

* 20-30 minutes of pain education modules in the VR environment
* Information on the neurophysiological basis of pain, catastrophizing, and fear-avoidance behaviors
* Reinforcement with interactive questions and short exercises
2. Weekly Reinforcement (Weeks 2-6)

* 10-15 minutes of short VR modules each week
* Integration with core exercise sessions

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Core Stabilization Exercises

Individuals in this group will undergo classical pain education (based on visual presentation or face-to-face instruction) along with core stabilization exercises targeting the muscles surrounding the spine. The exercises will be organized according to protocols reported in the literature as safe and effective and will include the following elements:

* Exercises that activate the transversus abdominis and multifidus muscles (e.g., abdominal bracing, bird-dog, plank, side bridge)
* Posture and spinal control exercises
* Stretching and mobilization movements (lumbar flexion/extension, hip flexor stretches)
* Each exercise will be performed in 2-3 sets of 10-15 repetitions, with the load increased according to participant tolerance.

Intervention Type OTHER

Classic Pain Neuroscience Education

During the application process, participants will be provided with traditional educational materials (e.g., verbal explanations or informational brochures) on the physiological basis of pain, movement safety, and pain management related to exercise. This training will not include virtual reality support.

Intervention Type OTHER

Virtual Reality-supported pain neuroscience education program

Details of the Virtual Reality-supported pain neuroscience education program:

1. Introductory Session (Week 1)

* 20-30 minutes of pain education modules in the VR environment
* Information on the neurophysiological basis of pain, catastrophizing, and fear-avoidance behaviors
* Reinforcement with interactive questions and short exercises
2. Weekly Reinforcement (Weeks 2-6)

* 10-15 minutes of short VR modules each week
* Integration with core exercise sessions

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Be between the ages of 18 and 65
* Have a diagnosis of nonspecific low back pain with a history of low back pain lasting at least 3 months
* Have no specific pathologies that could cause low back pain (e.g., tumor, infection, fracture, inflammatory disease)
* Be able to walk independently and have the capacity to exercise
* Mini Mental State Examination score \>23

Exclusion Criteria

* Individuals who have undergone lumbar surgery within the last year,
* Individuals with central or peripheral neurological disorders (e.g., multiple sclerosis, peripheral neuropathy, Parkinson's disease),
* Those with vestibular, visual, or balance disorders (those at risk of dizziness or nausea during virtual reality applications),
* Those with serious cardiopulmonary or systemic diseases,
* Those with psychiatric disorders or a diagnosis of severe depression, those who are pregnant
* Individuals with a history of dizziness, epilepsy, or visual disturbances associated with virtual reality use
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Kirsehir Ahi Evran Universitesi

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

İrem CANLI

Research Assistant

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Kırşehir Ahi Evran University

Merkez, Kirşehi̇r, Turkey (Türkiye)

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Turkey (Türkiye)

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

İrem CANLI, Ph.D

Role: CONTACT

Phone: +905348377384

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

İrem CANLI

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

23591230588=

Identifier Type: -

Identifier Source: org_study_id