To our knowledge, no studies have better investigated the effect of Core Stabilization Exercises using VR on ankle and trunk proprioception in patients with CLBP and in turn on postural stability.
Background: Low Back Pain (LBP), one of the most critical disability causatives, has been associated with neuromuscular and biomechanical manifestations related to the deficiency of postural control and stability. Virtual reality (VR) core stabilization exercises (CSE) has proven previously to be effective in improving postural control among conditions with different proprioceptive damage mechanisms other than those affected with LBP. The Aim of this study is to explore the differing effects of this treatment regimen on postural stability in relation to lumbar and ankle proprioception in a population of participants with LBP. Design and Methods: a randomized clinical trial encompassing 44 participants of both genders. Participants with Chronic Low Back Pain (CLBP) will be randomized to one of two treatment groups: an Experimental group receiving VR stabilization exercises and a Control group receiving CSE only without VR simulations inaddition to patient instructions and education of both groups. Parameters of postural stability, ankle and trunk proprioception, pain intensity, balance interference with activity and psychological aspects of pain interference with activity will be measured by a force plate, iPhone applications, visual analog scale (VAS), the Activities-specific Balance Confidence (ABC) scale, Pain Catastrophizing Scale (PCS) and the Pain Self-Efficacy Questionnaire (PSEQ-Ar) respectively. Outcome measures will be collected at baseline, immediately after 1st treatment and after the last treatment session. Treatment regimens will consist of 12 sessions in 3 weeks using virtual reality glasses. Statistical Analysis: A linear mixed model will be used to analyze within- and between-group differences at the baseline, 6th session and twelfth sessions (repeated measures will be set as GROUP with two levels and TIME with three levels). Bonferroni post-hoc procedures will be used for multiple comparisons of the differences over time. Intention-to-treat analysis shall be utilized. Statistical significance was set at P \< 0.05.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
44
Virtual Reality (VR) Stabilization Exercises
Regular Stabilization Exercises
a unified form of patient instructions and education in regards of LBP
Dammam Medical Complex
Dammam, Eastern Province, Saudi Arabia
Postural stability
Centre of Pressure (CoP) movements will be tracked by a multi-sensory platform + Body Weight Balance (static):
Time frame: 12 weeks
Proprioception
Ankle and Trunk Joint Position Sense (JPS)
Time frame: 12 weeks
Pain Intensity
Visual Analog Scale (VAS)
Time frame: 12 weeks
Pain Self-Efficacy Questionnaire (PSEQ-Ar)
to examine one's beliefs, level of Pain intensity and actual achievements contributions to performance
Time frame: 12 weeks
Activities-specific Balance Confidence (ABC)
Active clinical assessment measures of balance and function
Time frame: 12 weeks
Pain Catastrophizing Scale
Overstressed undesirable perceptions of pain and the ambiance surrounding its involvement
Time frame: 12 weeks
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