The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Comparing VR-Based Exercises and Routine Physical Therapy Effects on Pain, Kinesiophobia, and Functional Abilities in Non-Specific Chronic Low Back Pain Patients “A Randomized Clinical Trial“

Document Type : RESEARCH PAPER

Authors
Fatimah khalifeh 1
Noureddin Karimi 1
Mohammad Hassan Azarsa 1
Somayeh Mohamadi 1
Samaneh HosseinZadeh 2
Saeed Behzadipour 3
Pezhman Masoudi 1
1 Neuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2 School of Public Health, Iran University of Medical Sciences, Tehran, Iran
3 Mechanical Engineering, Sharif University Of Technology, Tehran, Iran
10.22038/abjs.2025.87696.3971
Abstract
Objectives: To compare the effects of Virtual Reality (VR)-based exercises and routine physical therapy on pain, kinesiophobia, and functional abilities in patients with Non-Specific Chronic Low Back Pain (NSCLBP).
Methods: Twenty-eight participants aged 20 to 55 were included and randomly assigned to two groups, ensuring single blinding. Both groups received routine physical therapy, which included transcutaneous electrical nerve stimulation (TENS), ultrasound therapy, and infrared light, along with identical exercise programs. The intervention group also engaged in additional exercises using VR technology. Participants had been experiencing NSCLBP for three months or longer.
Results: The intervention group showed significant improvements in pain (P=0.001), disability index, quality of life (QoL) (P=0.004), range of motion (ROM) in flexion and extension (P=0,008, P=0.002), and both left and right sided balance (P=0.001, P=0.013) compared to the control group. However, no significant differences were observed in the Tampa Scale of Kinesiophobia (P=0.148) and strength in flexion and extension (P=0.370, P=0.09).
Conclusion: VR-based therapeutic exercises significantly improved pain, disability, quality of life, and balance in NSCLBP patients compared to routine physical therapy interventions.
Level of evidence: I
Keywords
: Kinesiophobia
Low Back Pain
Physical Therapy Modalities
Virtual Reality
Wearable Electronic Devices
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 9
September 2026
Pages 616-629

  • Receive Date 06 May 2025
  • Revise Date 06 January 2026
  • Accept Date 29 November 2025