Virtual Reality-Based Rehabilitation Versus Conventional Therapy in Patients With Chronic Low Back Pain

This study aims to evaluate the effectiveness of rehabilitation using virtual reality compared with conventional physiotherapy in patients with chronic low back pain. The study will be conducted as a prospective, randomized controlled trial including 80 patients aged 40-65 years diagnosed with chronic low back pain lasting at least three months. Participants will be randomly assigned to two groups: an experimental group receiving conventional rehabilitation supplemented with non-immersive virtual reality training using the Tecnobody Homing Studio system, and a control group receiving conventional rehabilitation alone. Both groups will participate in a four-week rehabilitation program. The virtual reality training will replace a portion of conventional exercises and will focus on improving movement quality, postural control, coordination, and functional mobility through interactive tasks with visual and auditory biofeedback. The system utilizes a 3D camera enabling markerless motion analysis and real-time visual feedback to support movement correction and identification of functional deficits. Outcome measures will include assessments of balance, posture, joint mobility, lower limb strength and endurance, pain intensity, pressure pain threshold, kinesiophobia, perceived stress, anxiety and depression, functional disability, quality of life, and motivation for physical activity. Measurements will be conducted at baseline, immediately after completion of the four-week rehabilitation program, and at an eight-week follow-up. The results of this study are expected to provide clinical evidence regarding the effectiveness of virtual reality-assisted rehabilitation in patients with chronic low back pain and may contribute to the development of evidence-based rehabilitation strategies incorporating digital technologies.

Chronic low back pain is one of the most prevalent musculoskeletal disorders worldwide and represents a major public health problem due to its high socioeconomic burden and its impact on functional capacity, quality of life, and work ability. In addition to physical impairments, patients with chronic low back pain frequently present psychosocial factors such as fear of movement (kinesiophobia), stress, anxiety, and depressive symptoms, which may contribute to the persistence of pain and disability. Conventional physiotherapy remains a cornerstone in the management of chronic low back pain. Treatment usually includes therapeutic exercises aimed at improving spinal mobility, postural control, muscular strength, balance, and functional movement patterns. Despite the effectiveness of exercise-based rehabilitation, maintaining patient motivation and long-term adherence to therapy may be difficult, particularly in individuals with persistent symptoms. In recent years, virtual reality technologies have been increasingly explored as supportive tools in rehabilitation. VR systems allow the creation of interactive therapeutic environments that provide real-time visual and auditory feedback. This type of feedback may facilitate motor learning, improve movement quality, and increase patient engagement during therapy. The aim of this study is to evaluate the effectiveness of rehabilitation supported by virtual reality compared with conventional physiotherapy in patients with chronic low back pain. The study will be conducted as a prospective randomized controlled trial including 80 participants aged 40-65 years diagnosed with chronic low back pain lasting at least three months. The age range of 40-65 years was selected in order to reduce functional heterogeneity within the study population and to limit the influence of age-related factors on balance, mobility, and postural control. Individuals in this age group represent a population frequently affected by chronic low back pain while generally maintaining sufficient functional capacity to participate in a structured rehabilitation program. Participants will be assigned to one of two groups: an experimental group receiving conventional rehabilitation supplemented with non-immersive virtual reality training and a control group receiving conventional rehabilitation alone. The rehabilitation program will last four weeks. Participants will be monitored for potential adverse events during the rehabilitation program. Particular attention will be paid to symptoms potentially associated with the use of virtual reality, such as dizziness, nausea, visual discomfort, or increased pain. Any adverse events reported by participants or observed by the physiotherapist will be documented. Adherence to the rehabilitation program will be monitored by recording attendance at each therapy session in a standardized therapy record maintained by the treating physiotherapist. The record will document the number of completed ses Покажи пълното описание...

Inclusion Criteria: * Diagnosis of chronic low back pain lasting at least 3 months * Average pain intensity ≥4/10 during the previous week on the Numeric Rating Scale (NRS) * Age between 40 and 65 years * Ability to walk independently without assistive devices * Functional disability related to low back pain defined as Oswestry Disability Index (ODI) ≥15% * No contraindications to participation in a physiotherapy program or virtual reality training * Ability to understand study procedures and follow instructions * Written informed consent to participate in the study Exclusion Criteria: * Acute low back pain or pain lasting less than 3 months * Neurological, orthopedic, rheumatological, oncological diseases or active inflammatory conditions that may affect study outcomes * Cognitive impairment limiting the ability to understand instructions or participate in rehabilitation * Contraindications to virtual reality training such as severe dizziness, nausea, epilepsy, or severe visual or auditory impairment * Contraindications to body composition analysis (e.g., implanted cardiac pacemaker or other electronic implants) * Unstable medical condition or uncontrolled cardiovascular or respiratory disorders preventing participation in rehabilitation * Participation in other rehabilitation programs during the study period * Failure to complete the four-week rehabilitation program * Lack of written informed consent