Overview
The goal of this clinical trial is to compare the acute effects of virtual reality exergames (VR-EXG) and spinal manipulation on pain, kinesiophobia, mood states, functional disability and lumbar range of motion in individuals with chronic nonspecific low back pain.
The main questions it aims to answer are:
- Does a single session of VR-EXG affect pain, kinesiophobia, mood states, functional disability and lumbar range of motion in individuals with chronic nonspecific low back pain?
- Does a single session of spinal manipulation affect pain, kinesiophobia, mood states, functional disability and lumbar range of motion in individuals with chronic nonspecific low back pain?
- Is there a difference between VR-EXG and spinal manipulation in their acute effects on pain, kinesiophobia, mood states, functional disability and lumbar range of motion?
Researchers will compare participants receiving VR-EXG with those receiving spinal manipulation to determine whether one intervention produces greater acute improvements in pain, kinesiophobia, mood states, functional disability and lumbar range of motion.
Participants will be divided into two groups to be compared: the first group will receive virtual reality exergaming (VR-EXG), while the second group will receive spinal manipulation.
Description
Virtual reality (VR) is an emerging rehabilitation approach that can reduce pain , Kinesiophobia and functional disability in people with chronic nonspecific low back pain (CNSLBP). Spinal manipulation is a commonly used manual therapy that can provide short-term pain relief and improve physical function in CNSLBP. Both interventions may also influence psychological responses associated with chronic pain, including mood states and kinesiophobia. However, most studies have investigated VR and spinal manipulation separately rather than directly comparing their acute effects. Therefore, it remains unclear which intervention produces greater immediate improvements in pain, lumbar range of motion, mood states, functional disability and kinesiophobia. Comparing these interventions may address this gap and provide evidence on their relative acute effects in individuals with CNSLBP.
Eligibility
Inclusion Criteria:
- Adults aged 20-55 years
- Chronic nonspecific low back pain lasting at least 3 months.
- Pain intensity of ≥3/10 on the VAS at baseline.
- Ability to understand and follow the instructions and complete the VR-EXG and spinal-manipulation procedures.
- Ability to perform the required lumbar movements.
Exclusion Criteria:
- Specific spinal pathology, including fracture, spinal infection, malignancy, inflammatory/rheumatologic disease, or severe osteoporosis.
- Previous lumbar or spinal surgery.
- Neurological conditions or progressive neurological deficits, including significant radicular symptoms.
- Serious cardiovascular, systemic, or other medical conditions that contraindicate physical exercise or spinal manipulation.
- Pregnancy.
- Current acute injury or condition that would prevent safe participation in VR-EXG or spinal manipulation.
- Previous adverse reaction or contraindication to spinal manipulation.
- Vestibular disorders, severe dizziness, or other conditions that could interfere with safe VR use.
- Significant visual or auditory impairment that prevents participation in the VR intervention.
- Inability to understand or perform the intervention or outcome assessments.
- Use of analgesic medication within 48 hours before assessment/intervention.
