Effectiveness of Virtual Reality in Patients With Chronic Neck Pain

Investigation of the Effectiveness of Virtual Reality Applications in Addition to Exercise Program in People With Chronic Neck Pain

Virtual reality application has been increasing in recent years for pain control, distraction in wound care, treatment of anxiety disorders and support for physical rehabilitation. For example, it has been found to be effective in reducing pain when used in addition to medical treatment during bandaging of severe burns. The studies related with chronic pain patients were stated that virtual reality application was found to be interactive and fun by patients. Therefore, The aim of this study was to investigate the effects of virtual reality on pain threshold, disability, balance, proprioception, exercise sustainability, muscular performance in neck region, quality of life and anxiety / depression in addition to the exercise program that includes stabilization exercises in patients with chronic neck pain.

Study Overview

• Status: Completed
• Conditions: Virtual Reality; Proprioception; Balance; Pain, Neck
• Intervention / Treatment: Other: Virtual Reality

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey
    • Hacettepe University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 61 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• to have pain more than 3 months,
• to be sedentary,
• to have Neck Disability Index score more than 10.

Exclusion Criteria:

• to have neurological deficits, vestibular pathology, history of surgery.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Virtual Reality; Virtual Reality + Exercise	Other: Virtual Reality; Virtual reality group will have virtual reality for 20 minutes in addition to motor control exercises for 20 minutes. Virtual reality will apply using Oculus Go. On the other hand control group will have only exercise for 40 minutes. Exercises will include same exercises in both groups, but exercise group will perform exercises twice compared to virtual reality group.; Other Names: Exercise
Other: Exercise; Exercise Only	Other: Virtual Reality; Virtual reality group will have virtual reality for 20 minutes in addition to motor control exercises for 20 minutes. Virtual reality will apply using Oculus Go. On the other hand control group will have only exercise for 40 minutes. Exercises will include same exercises in both groups, but exercise group will perform exercises twice compared to virtual reality group.; Other Names: Exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Joint position sense error will assessed by Cervical Range of Motion device.	Joint position sense error will assessed by Cervical Range of Motion device.	Change from baseline joint position sense error (cervical flexion, extension, lateral flexions and rotations) after 6 weeks.
Balance will assessed by Dynamic Posturography.	Balance will assessed by Dynamic Posturography.	Change from baseline sensorial organization test (vestibular, visual and proprioceptive components), limits of stability (reaction time, movement velocity, endpoint excursion, maximum excursion, directional control) and unilateral stance after 6 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
cervical lordosis angle	Angle will measure using the plane of the superior vertebral plateau of C7 vertebra and of the inferior plateau of C2.	Change from baseline cervical lordosis after 6 weeks.
Kinesiophobia will assessed by Tampa kinesiophobia Scale	Kinesiophobia will assessed by Tampa kinesiophobia Scale	Change from baseline kinesiophobia after 6 weeks.
Quality of life will assessed by Short-form 36.	Quality of life will assessed by Short-form 36.	Change from baseline quality of life after 6 weeks.
Disability will assessed by Profile Fitness Mapping Questionnaire(Turkish).	Disability will assessed by Profile Fitness Mapping Questionnaire(Turkish).	Change from baseline disability after 6 weeks.
Anxiety-depression will assessed by Hospital Anxiety-depression scale.	Anxiety-depression will assessed by Hospital Anxiety-depression scale.	Change from baseline anxiety-depression after 6 weeks.
Shoulder protraction and forward head posture were assessed by photography method.	Shoulder protraction and forward head posture were assessed by photography method.	Change from baseline shoulder protraction and forward head posture after 6 weeks.
Pain threshold will assessed by algometer device.	Pain threshold will assessed by algometer device.	Change from baseline pain threshold of both the right and left upper trapezius, the right and left articular pillar between cervical 1 and 2, the right and left cervical 5 and 6 after 6 weeks.
Pain intensity will assessed with Visual Analog Scale.	Pain intensity will assessed with Visual Analog Scale.	Change from baseline pain intensity after 6 weeks.
muscle strength will assessed by dynamometer and biofeedback device	muscle strength will assessed by dynamometer and biofeedback device	Change from baseline muscle strength after 6 weeks.

Collaborators and Investigators

• Sponsor: Hacettepe University
• Investigators: Study Director: Halil Kamil Öge, Hacettepe University

Publications and helpful links

General Publications

• Li A, Montano Z, Chen VJ, Gold JI. Virtual reality and pain management: current trends and future directions. Pain Manag. 2011 Mar;1(2):147-157. doi: 10.2217/pmt.10.15.
• Tashjian VC, Mosadeghi S, Howard AR, Lopez M, Dupuy T, Reid M, Martinez B, Ahmed S, Dailey F, Robbins K, Rosen B, Fuller G, Danovitch I, IsHak W, Spiegel B. Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial. JMIR Ment Health. 2017 Mar 29;4(1):e9. doi: 10.2196/mental.7387.

Study record dates

Study Major Dates

• Study Start (Actual): October 30, 2020
• Primary Completion (Actual): September 30, 2021
• Study Completion (Actual): October 10, 2021

Study Registration Dates

• First Submitted: July 5, 2019
• First Submitted That Met QC Criteria: July 9, 2019
• First Posted (Actual): July 10, 2019

Study Record Updates

• Last Update Posted (Actual): July 1, 2022
• Last Update Submitted That Met QC Criteria: June 28, 2022
• Last Verified: June 1, 2022

More Information

Terms related to this study

• Keywords: neck pain; virtual reality; proprioception; balance
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: VR2805

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No