Effectiveness of Virtual Reality in Patients With Chronic Neck Pain

Study Overview
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Brief Summary
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Virtual reality application has been increasing in recent years for pain control, distraction in wound care, treatment of anxiety disorders and support for physical rehabilitation. For example, it has been found to be effective in reducing pain when used in addition to medical treatment during bandaging of severe burns. The studies related with chronic pain patients were stated that virtual reality application was found to be interactive and fun by patients. Therefore, The aim of this study was to investigate the effects of virtual reality on pain threshold, disability, balance, proprioception, exercise sustainability, muscular performance in neck region, quality of life and anxiety / depression in addition to the exercise program that includes stabilization exercises in patients with chronic neck pain.

Official Title
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Investigation of the Effectiveness of Virtual Reality Applications in Addition to Exercise Program in People With Chronic Neck Pain

Conditions
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Pain, Neck, Virtual Reality, Proprioception, Balance

Intervention / Treatment
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* Other: Virtual Reality


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: to have pain more than 3 months, to be sedentary, to have Neck Disability Index score more than 10. Exclusion Criteria: to have neurological deficits, vestibular pathology, history of surgery.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Virtual Reality
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Reality<br>Virtual Reality + Exercise | Other: Virtual Reality<br>* Virtual reality group will have virtual reality for 20 minutes in addition to motor control exercises for 20 minutes. Virtual reality will apply using Oculus Go. On the other hand control group will have only exercise for 40 minutes. Exercises will include same exercises in both groups, but exercise group will perform exercises twice compared to virtual reality group.<br>* Other names: Exercise;|
| Other: Exercise<br>Exercise Only | Other: Virtual Reality<br>* Virtual reality group will have virtual reality for 20 minutes in addition to motor control exercises for 20 minutes. Virtual reality will apply using Oculus Go. On the other hand control group will have only exercise for 40 minutes. Exercises will include same exercises in both groups, but exercise group will perform exercises twice compared to virtual reality group.<br>* Other names: Exercise;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Joint position sense error will assessed by Cervical Range of Motion device. | Joint position sense error will assessed by Cervical Range of Motion device. | Change from baseline joint position sense error (cervical flexion, extension, lateral flexions and rotations) after 6 weeks. | 
| Balance will assessed by Dynamic Posturography. | Balance will assessed by Dynamic Posturography. | Change from baseline sensorial organization test (vestibular, visual and proprioceptive components), limits of stability (reaction time, movement velocity, endpoint excursion, maximum excursion, directional control) and unilateral stance after 6 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cervical lordosis angle | Angle will measure using the plane of the superior vertebral plateau of C7 vertebra and of the inferior plateau of C2. | Change from baseline cervical lordosis after 6 weeks. | 
| Kinesiophobia will assessed by Tampa kinesiophobia Scale | Kinesiophobia will assessed by Tampa kinesiophobia Scale | Change from baseline kinesiophobia after 6 weeks. | 
| Quality of life will assessed by Short-form 36. | Quality of life will assessed by Short-form 36. | Change from baseline quality of life after 6 weeks. | 
| Disability will assessed by Profile Fitness Mapping Questionnaire(Turkish). | Disability will assessed by Profile Fitness Mapping Questionnaire(Turkish). | Change from baseline disability after 6 weeks. | 
| Anxiety-depression will assessed by Hospital Anxiety-depression scale. | Anxiety-depression will assessed by Hospital Anxiety-depression scale. | Change from baseline anxiety-depression after 6 weeks. | 
| Shoulder protraction and forward head posture were assessed by photography method. | Shoulder protraction and forward head posture were assessed by photography method. | Change from baseline shoulder protraction and forward head posture after 6 weeks. | 
| Pain threshold will assessed by algometer device. | Pain threshold will assessed by algometer device. | Change from baseline pain threshold of both the right and left upper trapezius, the right and left articular pillar between cervical 1 and 2, the right and left cervical 5 and 6 after 6 weeks. | 
| Pain intensity will assessed with Visual Analog Scale. | Pain intensity will assessed with Visual Analog Scale. | Change from baseline pain intensity after 6 weeks. | 
| muscle strength will assessed by dynamometer and biofeedback device | muscle strength will assessed by dynamometer and biofeedback device | Change from baseline muscle strength after 6 weeks. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neck pain, virtual reality, proprioception, balance