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

NCT07305597 | Recruiting

• 1 other identifier: 23591230588=
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 2

Brief Summary

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.

Conditions

Chronic Non-Specific Low Back Pain

Keywords

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

Outcome Measures

Primary Outcomes (2)

• Severity of Pain

  A visual analog scale will be used to assess patients' current pain intensity. This scale is one of the most commonly used scales for assessing pain intensity during rest, activity, and at night. The scale features a 10 cm line on which the patient can mark their pain intensity. Patients are asked to indicate the degree of their pain intensity on the line, ranging from no pain (left side) to unbearable pain (right side).

  6 week

• Functional Status

  The level of disability resulting from low back pain will be assessed using the Oswestry Disability Index (ODI). The ODI was developed by Fairbank et al. in 1980, and its Turkish validity and reliability were established by Yakut et al. The ODI is one of the most widely used instruments for determining the extent to which daily living activities and functional status are affected by pain in individuals with low back pain.

  6 week

Secondary Outcomes (2)

• Balance

  6 week

• Pain Catastrophizing

  6 week

Study Arms (2)

Core Stabilization + Classic Pain Neuroscience Education

EXPERIMENTAL

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

Other: Core Stabilization Exercises; Other: Classic Pain Neuroscience Education

Core Stabilization + Virtual Reality-Assisted Pain Neuroscience Education

EXPERIMENTAL

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

Other: Core Stabilization Exercises; Other: Virtual Reality-supported pain neuroscience education program

Interventions

Core Stabilization Exercises 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.

Core Stabilization + Classic Pain Neuroscience Education; Core Stabilization + Virtual Reality-Assisted Pain Neuroscience Education

Classic Pain Neuroscience Education 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 + Classic Pain Neuroscience Education

Virtual Reality-supported pain neuroscience education program 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

Core Stabilization + Virtual Reality-Assisted Pain Neuroscience Education

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

Study Sites (2)

Kırşehir Ahi Evran University

Center, Kirşehi̇r, 40100, Turkey (Türkiye)

NOT YET RECRUITING

Kırşehir Ahi Evran University

Kırşehir, Turkey (Türkiye)

RECRUITING

Central Study Contacts

İrem CANLI, Ph.D

CONTACT

+905348377384; iremvalamur@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant

Model Details: Randomized dontrolled trial

Study Record Dates

• First Submitted: December 13, 2025
• First Posted: December 26, 2025
• Study Start: January 15, 2026
• Primary Completion: May 1, 2026
• Study Completion (Estimated): May 15, 2026
• Last Updated: February 27, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (2)