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

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

Interventional

Enrollment (Estimated)

60

Phase

  • 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

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

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
Intervention / Treatment
Experimental: Arm 1: Gamified Intervention Group

A four-week home-based 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.

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

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

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.

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)

November 1, 2026

Primary Completion (Estimated)

February 20, 2027

Study Completion (Estimated)

February 28, 2027

Study Registration Dates

First Submitted

October 15, 2026

First Submitted That Met QC Criteria

October 15, 2026

First Posted (Actual)

October 22, 2026

Study Record Updates

Last Update Posted (Actual)

November 9, 2026

Last Update Submitted That Met QC Criteria

November 4, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

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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