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Effect of VR-MBCT in Chronic Nonspecific Low Back Pain (VR-MBCT-CNLBP)

Effect of Virtual Reality-Based Mindfulness-Based Cognitive Therapy in Patients With Chronic Nonspecific Low Back Pain: Protocol for a Prospective, Multi-Center, Open-Label Randomized Controlled Trial

This is a multi-center, prospective, open-label randomized controlled trial evaluating the efficacy and safety of virtual reality-based mindfulness-based cognitive therapy (VR-MBCT) as an adjunct to usual care in adults with chronic nonspecific low back pain (CNLBP). A total of 214 participants aged 20-70 years with pain duration ≥3 months and average back pain bothersomeness ≥4 (0-10 scale) will be enrolled from three hospitals in China and randomized 1:1 to an 8-week VR-MBCT intervention group or a waitlist usual care control group. The co-primary outcomes are the proportions of patients achieving ≥30% improvement from baseline in Oswestry Disability Index (ODI) and self-rated back pain bothersomeness at week 8. Secondary outcomes include pain intensity (NRS), global improvement, anxiety (GAD-7), depression (PHQ-9), physical activity (IPAQ-SF), sleep quality (SQS), fear-avoidance beliefs (FABQ-PA), pain catastrophizing (PCS), work productivity (WPAI-GH), treatment use, system usability (SUS), and patient satisfaction. Safety will be monitored for VR-related adverse events. Assessments will be performed at baseline (T0), week 4 (T1), week 8 (T2), and week 26 (T3). Data will be analyzed following the intention-to-treat principle using mixed-effects models and per-protocol analyses.

연구 개요

상세 설명

Chronic nonspecific low back pain (CNLBP) is a leading global cause of disability, yet conventional treatments often focus on structural damage and neglect cognitive, emotional, and behavioral dimensions. Mindfulness-based cognitive therapy (MBCT) is effective for chronic pain but limited by therapist resources and low adherence. Virtual reality (VR) provides an immersive, standardized platform to improve treatment fidelity, engagement, and scalability. This multi-center randomized controlled trial investigates a tailored 8-week VR-MBCT intervention for CNLBP.

The intervention group receives a hybrid VR-MBCT program consisting of 1 weekly in-clinic VR session (approximately 30 minutes) plus at least 3 home-based audio practice sessions (20-30 minutes per session) for 8 weeks. The progressive curriculum includes automatic pilot and awareness, body scan, mindful movement, graded exposure, responding versus reacting, cognitive defusion, self-compassion, relapse prevention, self-care, and real-world transfer training. The control group receives usual medical care only during the 8-week study period and will be offered the same VR-MBCT intervention after completing the 26-week follow-up.

Outcome assessments are conducted at baseline (T0), week 4 (T1), week 8 (T2), and week 26 (T3). Co-primary outcomes are the proportion of participants achieving ≥30% improvement in Oswestry Disability Index (ODI) and back pain bothersomeness (0-10 scale) at week 8. Secondary outcomes include pain intensity (NRS), global improvement, depression (PHQ-9), anxiety (GAD-7), physical activity (IPAQ-SF), sleep quality (SQS), fear-avoidance beliefs (FABQ-PA), pain catastrophizing (PCS), work productivity and activity impairment (WPAI-GH), and use of concomitant treatments. System usability scale (SUS) and patient satisfaction are assessed in the intervention group only. Safety assessments include monitoring and grading of VR-related adverse events such as dizziness, nausea, eye fatigue, headache, and falls at each contact.

Randomization is performed using a computer-generated sequence with 1:1 allocation, stratified by sex and pain duration (<2 years versus ≥2 years). Outcome assessors and statisticians are blinded to group assignment. Data management follows Good Clinical Practice (GCP) with double-entry verification and independent monitoring. This study will provide evidence for VR-MBCT as a scalable, standardized, non-pharmacological adjunctive intervention for CNLBP.

연구 유형

중재적

등록 (추정된)

214

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 연락처 백업

  • 이름: Panqi Wang, MD Candidate
  • 전화번호: +86 188 9690 3118
  • 이메일: 2744237372@qq.com

연구 장소

    • Jiangsu
      • Suzhou, Jiangsu, 중국, 215006
        • 모병
        • The First Affiliated Hospital of Soochow University
        • 연락하다:
        • 연락하다:
        • 수석 연구원:
          • Xiaohong Jin, MD, PHD
        • 부수사관:
          • Panqi Wang, MSc

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

Patients who meet the following criteria will be included:

  1. Diagnosed with CNLBP according to standard criteria (3), with pain duration ≥3 months.
  2. Aged 20-70 years (inclusive), regardless of sex.
  3. Average self-reported back pain bothersomeness ≥4(scale, 0-10) in the past week.
  4. Provided informed consent and family members will be informed of the study as support persons.

Exclusion Criteria:

  1. Coexisting pain conditions that may interfere with the assessment of CNLBP
  2. Severe neurological or psychiatric disorders (e.g., unstable epilepsy, psychosis, dementia)
  3. Severe psychiatric comorbidities (e.g., active suicidal ideation, severe depression requiring antidepressant medication)
  4. History of substance abuse (including alcohol or drugs) in the past year
  5. History of accidents or injuries related to back pain in the past year
  6. Severe visual impairment, vertigo, or history of VR-induced motion sickness precluding safe VR use
  7. Inability to communicate effectively to express subjective feelings.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: VR-Based Mindfulness Cognitive Therapy Intervention Group
Participants in the intervention group will receive an 8-week VR-based telerehabilitation program integrating mindfulness-based cognitive therapy (MBCT), pain neuroscience education (PNE), and graded exposure principles, specifically designed for chronic non-specific low back pain (CNLBP) besides usual clinical care. The program will be delivered through a VR-MR system co-developed by the research team and a technology company in Hangzhou. The system will comprise a PICO Ultra VR-MR headset for immersive mixed-reality experiences and a DM-TG01A motion capture camera for real-time tracking of participant movements and postures. All equipment will be provided to participants at no cost.
활성 비교기: Waitlist Usual Care Control Group
The control group will receive standard clinical care (including pharmacological treatment, physical therapy, and home exercise as usual) without any structured VR training for the initial 8-week study period. After completing the 6-month follow-up assessment, control group participants will be offered the same 8-week VR-MBCT program based on their choices.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Proportion of participants achieving ≥30% improvement in Oswestry Disability Index (ODI) from baseline at Week 8
기간: Baseline, Week 8
Functional disability assessed by the validated Oswestry Disability Index (ODI, score range 0-100%). Treatment responder defined as achieving a minimum clinically important improvement of ≥30% reduction from baseline at week 8.
Baseline, Week 8
Proportion of participants achieving ≥30% improvement in self-reported back pain bothersomeness (0-10 scale) from baseline at Week 8
기간: Baseline, Week 8
Back pain bothersomeness rated on a 0-10 scale (0 = no bother, 10 = worst bothersomeness). Responder defined as ≥30% score reduction from baseline at week 8.
Baseline, Week 8

2차 결과 측정

결과 측정
측정값 설명
기간
NRS Pain Intensity
기간: Baseline, Week 8, Week 26
Change in average pain intensity assessed by 11-point Numerical Rating Scale (NRS)
Baseline, Week 8, Week 26
Global Pain Improvement
기간: Week 8, Week 26
Global self-reported pain improvement assessed by 7-point Likert scale
Week 8, Week 26
Anxiety (GAD-7)
기간: Baseline, Week 8, Week 26
Change in anxiety symptoms assessed by Generalized Anxiety Disorder 7-item scale (GAD-7)
Baseline, Week 8, Week 26
Depression (PHQ-9)
기간: Baseline, Week 8, Week 26
Change in depressive symptoms assessed by Patient Health Questionnaire 9-item scale (PHQ-9)
Baseline, Week 8, Week 26
Physical Activity (IPAQ-SF)
기간: Baseline, Week 8, Week 26
Change in physical activity level assessed by International Physical Activity Questionnaire Short Form (IPAQ-SF)
Baseline, Week 8, Week 26
Sleep Quality (SQS)
기간: Baseline, Week 8, Week 26
Change in overall sleep quality assessed by Single-item Sleep Quality Scale (SQS)
Baseline, Week 8, Week 26
Fear-Avoidance Beliefs (FABQ-PA)
기간: Baseline, Week 8, Week 26
Change in fear-avoidance beliefs toward physical activity assessed by FABQ-PA
Baseline, Week 8, Week 26
Pain Catastrophizing (PCS)
기간: Baseline, Week 8, Week 26
Change in pain catastrophizing level assessed by Pain Catastrophizing Scale(PCS)
Baseline, Week 8, Week 26
Work Productivity (WPAI-GH)
기간: Baseline, Week 8, Week 26
Change in work productivity and activity impairment assessed by Work Productivity and Activity Impairment General Health (WPAI-GH)
Baseline, Week 8, Week 26
Concomitant Treatment Use
기간: Baseline, Week 8, Week 26
Changes in the use of additional treatments and opioid medication for low back pain
Baseline, Week 8, Week 26
System Usability (SUS, Intervention group only)
기간: Week 8
System usability evaluated by System Usability Scale (SUS)
Week 8
Patient Satisfaction (Intervention group only)
기간: Week 8
Patient satisfaction and recommendation willingness rated on 0-10 scale
Week 8

기타 결과 측정

결과 측정
측정값 설명
기간
Incidence and severity of VR-related adverse events
기간: Immediately after each VR session, Week 4, Week 8, Week 26
VR-related adverse events (including dizziness, nausea, eye strain, headache, cold sweat, and anxiety) will be actively monitored immediately after each VR training session using a 4-point severity scale (0=absent, 1=mild, 2=moderate, 3=severe). All adverse events, including non-VR-related events, will also be collected and reviewed at scheduled follow-up visits (Week 4, Week 8, Week 26).
Immediately after each VR session, Week 4, Week 8, Week 26

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Xiaohong Jin, MD, PHD, The First Affiliated Hospital of Soochow University

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2026년 4월 1일

기본 완료 (추정된)

2027년 4월 1일

연구 완료 (추정된)

2027년 4월 1일

연구 등록 날짜

최초 제출

2026년 5월 10일

QC 기준을 충족하는 최초 제출

2026년 5월 10일

처음 게시됨 (실제)

2026년 5월 15일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 5월 15일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 5월 10일

마지막으로 확인됨

2026년 5월 1일

추가 정보

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이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

Virtual Reality-Based Mindfulness Cognitive Therapy (VR-MBCT)에 대한 임상 시험

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