Gamified Home-Based Core Neuromuscular Training for Chronic Low Back Pain

November 4, 2026 updated by: Zizi M Ibrahim, Princess Nourah Bint Abdulrahman University

Effect of a Gamified Home-Based Core Neuromuscular Training on Pain, Disability, and Core Endurance in Women With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

This randomized controlled trial aims to evaluate the effects of gamified home-based core neuromuscular training on pain intensity, functional disability, core muscular endurance, and exercise adherence in women with chronic nonspecific low back pain. Participants will be randomly allocated in a 1:1 ratio to either a gamified intervention group or a non-gamified control group. Both groups will perform the same progressive core exercise program. The intervention group will use a digital application with gamification features, while the control group will perform the exercises without gamification. Outcomes will be assessed at baseline and week 4. The study will determine whether gamification provides additional benefits over conventional home-based exercise in improving clinical outcomes and exercise adherence in women with chronic nonspecific low back pain.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Chronic nonspecific low back pain is associated with persistent pain and functional disability. Although home-based core exercises are commonly used in rehabilitation, maintaining exercise adherence can be challenging. Gamification may enhance motivation and engagement through interactive digital features.

This randomized controlled trial will recruit women aged 18-45 years with chronic nonspecific low back pain lasting at least 12 weeks and a baseline moderate pain intensity or more. Participants will be randomly allocated in a 1:1 ratio to a gamified intervention group or a non-gamified control group. Both groups will complete the same progressive home-based core exercise program for 4 weeks, with three sessions per week lasting 20-30 minutes. Exercises will include plank, side plank, foot-elevated side plank, dead bug, and bird dog. The intervention group will use a digital app, while the control group will perform the exercises without gamification.

Assessments will be conducted at baseline and week 4. Pain intensity will be measured using the Numeric Pain Rating Scale, functional disability using the Oswestry Disability Index, core muscular endurance using trunk flexor, trunk extensor, and side-bridge tests, and adherence as the percentage of completed sessions. The study aims to recruit 60 participants. Data will be analyzed using linear mixed-effects models to compare changes between groups over time. Ethical approval was obtained before recruitment, and written informed consent will be obtained from all participants.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Female participants aged 18-45 years.
  • Nonspecific low back pain persisting for at least 12 weeks.
  • Baseline pain intensity of ≥3 on the Numeric Pain Rating Scale (NPRS).
  • Ability to perform the prescribed core exercises safely.
  • Ownership of a compatible smartphone.
  • Internet access when required.

Exclusion Criteria:

  • Specific spinal pathology or serious medical conditions.
  • Previous spinal surgery.
  • Neurological symptoms affecting the lower limbs.
  • Pregnancy.
  • Severe musculoskeletal conditions limiting exercise.
  • Current participation in another low back pain rehabilitation program.
  • Any contraindication to exercise.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Arm 1: Gamified Intervention Group

A four-week home-based core neuromuscular exercise program using a digital application with gamification features.
Other: Gamified Intervention Group: core neuromuscular exercise program using a digital application with gamification features

a six-week home-based core neuromuscular exercise program using a digital application with gamification features. The program will include three sessions per week, each lasting approximately 20-30 minutes.
Active Comparator: Arm 2: Non-Gamified Control Group

Participants will perform the same four-week home-based core neuromuscular exercise program without gamification, with three sessions per week, each lasting approximately 20-30 minutes.
Other: Non-Gamified Control Group

six-week home-based core neuromuscular exercise program without gamification, with three sessions per week, each lasting approximately 20-30 minutes.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Pain Intensity: Pain Rating Scale (NPRS)
Time Frame: Baseline to Week 4(4weeks).

Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Changes in pain intensity will be compared between the gamified and non-gamified home-based core neuromuscular training groups.

Time Frame:
Baseline to Week 4(4weeks).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Oswestry Disability Index
Time Frame: Baseline to Week 4(4weeks)

The ODI is a validated, self-administered questionnaire used to assess functional disability associated with low back pain. It consists of 10 sections covering pain intensity and its impact on daily activities, including personal care, lifting, walking, sitting, standing, sleeping, sexual activity, social life, and traveling.

Each section contains six response options scored from 0 (no disability) to 5 (maximum disability). The total score is calculated by summing the completed sections and converting it into a percentage:

The total score is converted into a percentage by dividing the sum of the completed section scores by the maximum possible score (5 multiplied by the number of completed sections), then multiplying the result by 100. Higher percentages indicate greater functional disability.

Interpretation: Minimal (0-20%), Moderate (21-40%), Severe (41-60%), Very severe (61-80%), and Extreme (81-100%).
Baseline to Week 4(4weeks)
Core muscle endurance assessment 1
Time Frame: Baseline to Week 4(4weeks)

Trunk-Extensor-Test: hold time
Baseline to Week 4(4weeks)
Core muscle endurance assessment 2
Time Frame: Baseline to Week 4(4weeks)

Trunk Flexor Test: hold time
Baseline to Week 4(4weeks)
Core muscle endurance assessment 3
Time Frame: Baseline to Week 4(4weeks)

Side Bridge/Side Plank Test: hold time
Baseline to Week 4(4weeks)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Princess Nourah Bint Abdulrahman University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 20, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 28, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 15, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 15, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 22, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 26-0740

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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