NCT07305597

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

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 60 (estimated)
• Sponsor: Kirsehir Ahi Evran Universitesi · Academic / Other
• Sex: All
• Age: 18 Years – 65 Years
• Healthy volunteers: Not accepted

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.

Detailed description

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

• Chronic Non-Specific Low Back Pain

Interventions

Type	Name	Description
OTHER	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.
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.
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

Timeline

• Start date: 2026-01-15
• Primary completion: 2026-05-01
• Completion: 2026-05-15
• First posted: 2025-12-26
• Last updated: 2026-02-27

Locations

2 sites across 1 country: Turkey (Türkiye)