Skip to main content

Advertisement

Log in

Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

According to literature, virtual reality was found to reduce pain and kinesiophobia in patients with chronic pain. The purpose of the study was to investigate short-term effect of the virtual reality on pain, function, and kinesiophobia in patients with subacute and chronic non-specific low-back pain

Methods

This randomised controlled study in which 44 patients were randomly assigned to the traditional physiotherapy (control group, 22 subjects) or virtual walking integrated physiotherapy (experimental group, 22 subjects). Before and after treatment, Visual Analog Scale (VAS), TAMPA Kinesiophobia Scale (TKS), Oswestry Disability Index (ODI), Nottingham Health Profile (NHP), Timed-up and go Test (TUG), 6-Minute Walk Test (6MWT), and Single-Leg Balance Test were assessed. The interaction effect between group and time was assessed by using repeated-measures analysis of covariance.

Results

After treatment, both groups showed improvement in all parameters. However, VAS, TKS, TUG, and 6MWT scores showed significant differences in favor of the experimental group.

Conclusion

Virtual walking integrated physiotherapy reduces pain and kinesiophobia, and improved function in patients with subacute and chronic non-specific low-back pain in short term.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Al-Obaidi SM, Al-Zoabi B, Al-Shuwaie N, Al-Zaabie N, Nelson RM (2003) The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain. Int J Rehabil Res Internationale Zeitschrift Fur Rehabil Forschung Revue Internationale De Recherches De Readaptation 26(2):101–108. doi:10.1097/01.mrr.0000070750.63544.06

    Google Scholar 

  2. Apkarian AV, Sosa Y, Krauss BR, Thomas PS, Fredrickson BE, Levy RE, Harden RN, Chialvo DR (2004) Chronic pain patients are impaired on an emotional decision-making task. Pain 108(1–2):129–136. doi:10.1016/j.pain.2003.12.015

    Article  PubMed  Google Scholar 

  3. Boersma K, Linton SJ (2006) Psychological processes underlying the development of a chronic pain problem: a prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability. Clin J Pain 22(2):160–166

    Article  PubMed  Google Scholar 

  4. Booth V, Masud T, Connell L, Bath-Hextall F (2014) The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared with standard or no treatment: a systematic review and meta-analysis. Clin Rehabil 28(5):419–431. doi:10.1177/0269215513509389

    Article  PubMed  Google Scholar 

  5. Brox JI (2014) Current evidence on catastrophizing and fear avoidance beliefs in low back pain patients. Spine J Off J N Am Spine Soc 14(11):2679–2681. doi:10.1016/j.spinee.2014.08.454

    Article  Google Scholar 

  6. Flor H, Braun C, Elbert T, Birbaumer N (1997) Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neurosci Lett 224(1):5–8

    Article  CAS  PubMed  Google Scholar 

  7. Garcia-Palacios A, Herrero R, Vizcaino Y, Belmonte MA, Castilla D, Molinari G, Banos RM, Botella C (2015) Integrating virtual reality with activity management for the treatment of fibromyalgia: acceptability and preliminary efficacy. Clin J Pain 31(6):564–572. doi:10.1097/AJP.0000000000000196

    Article  PubMed  Google Scholar 

  8. Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res 63(Suppl 11):S240–252. doi:10.1002/acr.20543

    Article  Google Scholar 

  9. Henschke N, Ostelo RW, van Tulder MW, Vlaeyen JW, Morley S, Assendelft WJ, Main CJ (2010) Behavioural treatment for chronic low-back pain. Cochrane Database System Rev (7):CD002014. doi:10.1002/14651858.CD002014.pub3

  10. Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N (2014) Impact of low back pain, knee pain, and timed up-and-go test on quality of life in community-living people. J Orthop Sci Off J Japn Orthop Assoc 19(1):164–171. doi:10.1007/s00776-013-0476-0

    Google Scholar 

  11. Jiang Y, Wang S, Tan R, Ishida K, Ando T, MG. F (2013) Study of activation in motor cortex during mental imagery of walking using fNIRS. In: J. W (ed) Biomedical Engineering and Cognitive Neuroscience for Healthcare: Interdisciplinary Applications. IGI Global, USA, pp 29–37

  12. Jo HJ, Song AY, Lee KJ, Lee DC, Kim YH, Sung PS (2011) A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain. Euro Spine J Off Publ Euro Spine Soc Euro Spinal Deform Soc Euro Sect Cerv Spine Res Soc 20(8):1297–1303. doi:10.1007/s00586-010-1686-1

    Article  Google Scholar 

  13. Kim SS, Min WK, Kim JH, Lee BH (2014) The Effects of VR-based Wii Fit Yoga on Physical Function in Middle-aged Female LBP Patients. J Phys Therap Sci 26(4):549–552. doi:10.1589/jpts.26.549

    Article  Google Scholar 

  14. Kucukdeveci AA, McKenna SP, Kutlay S, Gursel Y, Whalley D, Arasil T (2000) The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res Internationale Zeitschrift Fur Rehabil Forschung Revue Internationale De Recherches De Readaptation 23(1):31–38

    CAS  Google Scholar 

  15. Lengenfelder J, Schultheis MT, Al-Shihabi T, Mourant R, DeLuca J (2002) Divided attention and driving: a pilot study using virtual reality technology. J Head Trauma Rehabil 17(1):26–37

    Article  PubMed  Google Scholar 

  16. Monticone M, Ambrosini E, Rocca B, Magni S, Brivio F, Ferrante S (2014) A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: results of a randomised controlled pilot study. Euro Spine J Off Publ Euro Spine Soc Euro Spinal Deform Soc Euro Sect Cerv Spine Res Soc 23(10):2105–2113. doi:10.1007/s00586-014-3478-5

    Article  Google Scholar 

  17. Morris LD, Grimmer-Somers KA, Spottiswoode B, Louw QA (2011) Virtual reality exposure therapy as treatment for pain catastrophizing in fibromyalgia patients: proof-of-concept study (Study Protocol). BMC Musculoskelet Dis 12(1):85. doi:10.1186/1471-2474-12-85

    Article  Google Scholar 

  18. Moseley GL (2008) Pain, brain imaging and physiotherapy–opportunity is knocking. Manual Therap 13(6):475–477. doi:10.1016/j.math.2008.10.001

    Article  Google Scholar 

  19. Oksuz E (2006) Prevalence, risk factors, and preference-based health states of low back pain in a Turkish population. Spine 31(25):E968–972. doi:10.1097/01.brs.0000247787.25382.3c

    Article  PubMed  Google Scholar 

  20. Park JH, Lee SH, Ko DS (2013) The Effects of the Nintendo Wii Exercise Program on Chronic Work-related Low Back Pain in Industrial Workers. J Phys Therap Sci 25(8):985–988. doi:10.1589/jpts.25.985

    Article  Google Scholar 

  21. Sato K, Fukumori S, Matsusaki T, Maruo T, Ishikawa S, Nishie H, Takata K, Mizuhara H, Mizobuchi S, Nakatsuka H, Matsumi M, Gofuku A, Yokoyama M, Morita K (2010) Nonimmersive virtual reality mirror visual feedback therapy and its application for the treatment of complex regional pain syndrome: an open-label pilot study. Pain Med 11(4):622–629. doi:10.1111/j.1526-4637.2010.00819.x

    Article  PubMed  Google Scholar 

  22. Schulz KF, Grimes DA (2002) Unequal group sizes in randomised trials: guarding against guessing. Lancet 359(9310):966–970. doi:10.1016/S0140-6736(02)08029-7

    Article  PubMed  Google Scholar 

  23. Tidstrand J, Horneij E (2009) Inter-rater reliability of three standardized functional tests in patients with low back pain. BMC Musculoskelet Dis 10:58. doi:10.1186/1471-2474-10-58

    Article  Google Scholar 

  24. Tunca Yılmaz Ö, Yakut Y, Uygur F (2011) Tampa Kinezyofobi Ölçeği’nin Türkçe versiyonu ve test-tekrar test güvenirliği. Fizyoter Rehabil 22(1):44–49

    Google Scholar 

  25. van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW (2011) A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Euro Spine J Off Publ Euro Spine Soc Euro Spinal Deform Soc Euro Sect Cervical Spine Res Soc 20(1):19–39. doi:10.1007/s00586-010-1518-3

    Article  Google Scholar 

  26. Wertli MM, Eugster R, Held U, Steurer J, Kofmehl R, Weiser S (2014) Catastrophizing-a prognostic factor for outcome in patients with low back pain: a systematic review. Spine J Off J N Am Spine Soc 14(11):2639–2657. doi:10.1016/j.spinee.2014.03.003

    Article  Google Scholar 

  27. Wertli MM, Rasmussen-Barr E, Held U, Weiser S, Bachmann LM, Brunner F (2014) Fear-avoidance beliefs-a moderator of treatment efficacy in patients with low back pain: a systematic review. Spine J Off J N Am Spine Soc 14(11):2658–2678. doi:10.1016/j.spinee.2014.02.033

    Article  Google Scholar 

  28. Wiederhold BK, Soomro A, Riva G, Wiederhold MD (2014) Future directions: advances and implications of virtual environments designed for pain management. Cyberpsychol Behav Soc Network 17(6):414–422. doi:10.1089/cyber.2014.0197

    Article  Google Scholar 

  29. Woolf CJ, Salter MW (2000) Neuronal plasticity: increasing the gain in pain. Science 288(5472):1765–1769

    Article  CAS  PubMed  Google Scholar 

  30. Yakut E, Duger T, Oksuz C, Yorukan S, Ureten K, Turan D, Frat T, Kiraz S, Krd N, Kayhan H, Yakut Y, Guler C (2004) Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine 29(5):581–585 (discussion 585)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gul Deniz Yilmaz Yelvar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yilmaz Yelvar, G.D., Çırak, Y., Dalkılınç, M. et al. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eur Spine J 26, 538–545 (2017). https://doi.org/10.1007/s00586-016-4892-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-016-4892-7

Keywords

Navigation