Investigation of the Effect of a Virtual Reality-Based Back School Program on Pain, Functionality, and Kinesiophobia

Investigation of the Effect of a Virtual Reality-Based Back School Program on Pain, Functionality, and Kinesiophobia

This study investigates the effects of a 4-week virtual reality (VR)-based back school program on pain, disability, fear of movement, and lumbar joint position sense (JPS) in individuals with chronic low back pain. Thirty-nine participants are allocated to either a VR-based back school group or a conventional back school group. Both groups perform supervised low back exercises. Pain, disability, proprioception, kinesiophobia, and perceived cognitive deficits are assessed before and after the intervention.

Background and Aim:

Chronic low back pain (CLBP) is a multidimensional condition associated with functional limitations, fear of movement, and proprioceptive impairments. Contemporary rehabilitation approaches, such as back school programs, are based on a biopsychosocial model and aim to enhance patient engagement. Virtual reality (VR) applications may further support these interventions by increasing motivation and providing enriched sensory feedback. This study aims to investigate the effects of a 4-week VR-based back school program on pain, disability, fear of movement, and joint position sense (JPS) in individuals with CLBP.

Methods:

The study includes 39 participants allocated into an experimental group (n=20) and a control group (n=19). The control group receives back school training through verbal instruction delivered by a physiotherapist, while the experimental group receives the same training integrated with a VR headset. Following the education sessions, both groups perform standard low back exercises under physiotherapist supervision.

Outcome measures include:

Pain intensity assessed using the Visual Analog Scale (VAS)

Disability assessed using the Oswestry Disability Index (ODI)

Lumbar joint position sense measured using a goniometric method

Fear of movement assessed using the Tampa Scale for Kinesiophobia (TSK)

Cognitive function assessed using the Perceived Deficits Questionnaire (PDQ)

All outcomes are evaluated before and after the 4-week intervention period.

Inclusion Criteria:

• Age between 18 and 65 years
• Presence of chronic low back pain for at least three months
• A resting pain intensity of 3 to 7 on the Visual Analog Scale (VAS)
• The cognitive ability to follow physiotherapy instructions
• Any physical therapy program within the previous 6 months

Exclusion Criteria:

• Neurological deficits
• Vestibular pathologies
• Major trauma
• Active infections
• Tumors,
• Inflammatory diseases
• They declined to participate.