The Short-Term Effects of Virtual Reality Versus Pain Neuroscience Education Versus Conventional Physiotherapy on Pain, Kinesiophobia, Catastrophizing, and Disability in Patients With Chronic Low Back Pain

This study addresses the prevailing issue of chronic low back pain (CLBP), which is a leading cause of disability worldwide. Non-specific chronic low back pain (NSCLBP), which lacks a clearly identifiable structural or pathological origin, is particularly challenging due to its multifactorial nature involving both physical and psychological components. Psychological aspects such as kinesiophobia (fear of movement) and pain catastrophizing significantly affect recovery and quality of life. The study aims to compare the short-term effectiveness of three distinct interventions like Virtual Reality (VR), Pain Neuroscience Education (PNE), and Conventional Physiotherapy (CP) in reducing pain intensity, fear of movement, catastrophizing, and disability among NSCLBP patients. This randomized controlled trial involves 81 participants aged between 18 and 50 years who meet specific inclusion criteria. They will be randomly divided into three equal groups: Group A will receives VR-based rehabilitation along with exercises, Group B will receives PNE combined with exercise therapy, and Group C will receives conventional physiotherapy. Outcome measures include the Visual Analog Scale (VAS), Tampa Scale of Kinesiophobia (TSK-17), Pain Catastrophizing Scale (PCS), Oswestry Disability Index (ODI), Pain Pressure Threshold, and lumbar range of motion assessments. Interventions are administered over four weeks, with pre- and post-assessments to evaluate effectiveness at baseline and 4th week. Virtual Reality is used to provide immersive, task-oriented activities that distract attention from pain and promote movement. PNE focuses on educating patients about the neurophysiological basis of pain to reduce fear and maladaptive beliefs. The conventional physiotherapy group follows standard treatments involving strengthening, stretching, and electrotherapy. The expected outcome is that both VR and PNE may yield superior psychological and functional benefits compared to CP. The study also explores the feasibility and acceptability of VR-based therapy in Indian clinical settings. By comparing these three approaches, this research aims to identify the most effective method for managing NSCLBP and contribute to evidence-based clinical decision-making.