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

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

Interventions

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

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-15

Primary Completion

2026-05-01

Completion

2026-05-15

Countries

• Turkey (Türkiye)

Study Locations