Effects of Virtual Reality-Assisted Pain Neuroscience Education on Chronic Nonspecific Low Back Pain
Effects of Virtual Reality-Assisted Pain Neuroscience Education on Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial
Kirsehir Ahi Evran Universitesi
60 participants
Jan 15, 2026
INTERVENTIONAL
Conditions
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.
Eligibility
Inclusion Criteria5
- 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 Criteria6
- 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
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
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 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.
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
Locations(2)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07305597