Low Back Pain, Postural
Conditions
Brief summary
To evaluate the effect of a virtual reality-based posture correction program on reducing low back pain intensity and improving dynamic balance in sedentary desk workers.
Detailed description
Low back pain (LBP) is one of the most common musculoskeletal disorders among desk workers and is strongly associated with prolonged sitting, poor posture, and reduced physical activity. Extended periods of desk work contribute to biomechanical and neuromuscular changes, including decreased lumbar lordosis, reduced spinal mobility, muscle tightness, impaired trunk muscle activation, and altered postural control. These changes may lead to chronic nonspecific low back pain, functional limitations, and deficits in dynamic balance. Postural deviations such as forward head posture, rounded shoulders, thoracic kyphosis, and pelvic misalignment are frequently observed in sedentary workers. These alterations affect spinal alignment and may impair proprioceptive input, resulting in decreased balance performance and inefficient neuromuscular control. Impaired balance and reduced sensorimotor awareness have been reported in individuals with chronic low back pain, increasing the risk of functional disability and musculoskeletal dysfunction. Virtual reality (VR)-based rehabilitation has emerged as an innovative approach for improving postural control and reducing pain. VR systems provide real-time visual feedback and interactive task-oriented exercises that promote active participation and enhance sensorimotor retraining. Through immersive environments, VR interventions may improve trunk muscle activation, proprioceptive awareness, motor coordination, and postural stability while increasing motivation and adherence to exercise programs. Dynamic posture correction exercises performed within a VR environment may provide additional benefits by integrating physical, cognitive, and sensory stimulation. Previous studies have demonstrated that VR-based interventions can reduce pain intensity, improve functional performance, enhance balance control, and decrease fear-avoidance behaviors associated with chronic pain conditions. Therefore, this study aims to investigate the effect of a virtual reality-based posture correction program on low back pain intensity and dynamic balance in desk workers. The findings may provide evidence regarding the effectiveness of VR-based posture correction as a rehabilitation strategy for addressing musculoskeletal and balance impairments associated with prolonged sedentary work.
Interventions
DEVICEvirtual reality
Participants in the intervention group will receive a virtual reality (VR)-based training program in addition to conventional physiotherapy. The intervention will consist of 12 treatment sessions, administered 3 times per week for 4 consecutive weeks. Each session will last approximately 30-35 minutes. The VR training will be delivered using commercially available exergaming and VR-based fitness applications, including Fit Beat Combat, Holo-point , and the EIR Training Fitness Program. These applications are designed to provide interactive, task-oriented exercises that challenge balance, coordination, postural control, and lower limb motor performance through engaging gameplay environments. Participants will be supervised during all sessions to ensure safety and proper performance of movements, and exercise intensity will be adjusted according to the participant's tolerance and performance.
OTHERpamphlet based ergonomics
Participants in the control group will receive a standardized educational pamphlet focusing on posture correction, ergonomic principles, and recommendations for maintaining proper body mechanics during daily activities and desk work. The pamphlet includes illustrated instructions and general advice aimed at reducing musculoskeletal strain. In addition, participants will attend a brief weekly educational and follow-up session conducted at their workplace, where key posture and ergonomic principles are reinforced and any questions are addressed. Furthermore, participants will be added to a daily reminder group (e.g., messaging group) to receive regular prompts and reminders to adhere to the recommended posture guidelines and exercises outlined in the pamphlet throughout the 4-week intervention period.
Sponsors
Kafrelsheikh University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Participants will be randomly assigned to two groups: a virtual reality-based posture correction group and a conventional physiotherapy group.
Eligibility
Sex/Gender
ALL
Age
25 Months to 60 Months
Healthy volunteers
Yes
Inclusion criteria
* Age between 25-60 years * Desk workers (≥ 5 hours daily seated work) * Chronic nonspecific low back pain lasting \> 3 months * Pain intensity between 2-6 on the Numeric Pain Rating Scale (NPRS) * No morbid obesity * No physical therapy within the last 3 months * Ability to understand and follow instructions * No visual or hearing impairments affecting VR use * Signed informed consent form
Exclusion criteria
* History of spinal surgery or spinal trauma * Neurological, neuromuscular, or vestibular disorders * Diabetes mellitus (Type I or II) * Cardiovascular or respiratory disorders * Thyroid dysfunction * Pregnancy * Medications affecting balance or alertness * Current smokers * Uncorrected visual impairments * Psychiatric disorders * History of frequent vertigo or cybersickness * Flat foot or foot deformities affecting balance * Polyneuropathy * Any condition affecting balance control * Participation in other exercise or rehabilitation programs * Inability or unwillingness to adhere to the study protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | baseline and 4 weeks | Pain intensity will be measured using the Visual Analog Scale (VAS), a 10-cm horizontal line anchored by "no pain" (0) and "worst imaginable pain" (10). Participants will indicate their perceived level of low back pain. Higher scores indicate greater pain intensity. |
| functional disability | baseline and 4 weeks | Functional disability will be assessed using the Oswestry Disability Index (ODI), a self-reported questionnaire consisting of 10 items evaluating limitations in daily activities. Total scores range from 0 to 100%, with higher scores indicating greater disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| dynamic balance | baseline and 4 weeks | Dynamic balance will be assessed using the Biodex Balance System. Balance performance will be quantified using the Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Medial-Lateral Stability Index (MLSI). Lower scores indicate better postural stability and neuromuscular control. |
Countries
Egypt
Outcome results
None listed