Modification of the Activity of the Prefrontal Cortex by Virtual Distraction in the Lumbago
Condition: Low Back Pain
MeSH terms: Low Back Pain
Study type: Interventional

Summary: 
      The hypothesis of this work is that distraction is an effective way to modify the feeling and
      experience of chronic lumbar pain by modifying the functioning of the prefrontal cortex.

      The main objective of this study is to show that during chronic low back pain generated
      during physical exercise, virtual reality distraction leads to the modification of the
      activity of the prefrontal cortex.

      The secondary objectives are:

        -  Show a significant decrease in the average pain assessed with EVA during physical
           exercise with virtual reality distraction.

        -  Show an increase in the distance travelled with virtual reality distraction.

        -  Observe a decrease in perceived effort with virtual reality distraction.

        -  Quantify the adherence (presence) of subjects to the virtual environment
    

Detailed description: 
      A pre-test phase at D0 will be carried out with the objective of individually determining the
      exercise conditions (speed and slope) of walking that will generate lumbar pain. Patients who
      have not experienced lumbar pain during this phase will be excluded from the study. The
      patients included are then randomized according to the order of physical exercise situations.

      For the tests, patients will be equipped with a miniaturized wireless (Octamon, Artinis) and
      multi-channel (8 optodes) NIRS device placed on the patient's frontal lobe according to EEG
      10-20 positioning (fig. 2). They will then be placed on an inclined treadmill according to
      the angle that caused the pain during the pre-test.

      During the test, subjects will walk to the voluntary stop and the different reasons for the
      stop (feeling of fatigue, pain, etc.) will be recorded by visual analogue scales and
      questionnaires. The duration of the exercise will be measured by a digital stopwatch
      connected to the treadmill. During physical exercise, the bilateral activity of the
      prefrontal cortex will be recorded continuously at a sampling frequency of 10 Hz.

      For each test, subjects will be confronted with 2 situations, on D1 and D2. In a situation,
      walking will be done without distraction. In the other situation, the patient will be placed
      in front of a screen with virtual reality simulation while performing the walking exercise.
    

Intervention name(s): measurement of bilateral activity of the prefrontal cortex by a NIRS system (near infrared spectroscopy); completion of questionnaires; completion of questionnaires for pain
Intervention type(s): Other; Other; Other
Intervention description(s): measurement of the cerebral oxygenation response by the use of the Near Infrared Spectroscopy (NIRS) method; igroup presence questionnaire (IPQ), Dallas Pain Questionnaire (DRAD), Fear-Avoidance Beliefs (FABQ) and Quebec Back Lumbago Scale; analogical visual and numerical scale and Borg scale
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Other