Virtual reality or isokinetic training; its effect on pain, kinesiophobia and serum stress hormones in chronic low back pain: A randomized controlled trial

Abstract

BACKGROUND: Evidence on the latest technologies in rehabilitation for reducing pain and altering serum stress hormones in low back pain (LBP) was lacking. OBJECTIVE: To find the clinical and hormonal effects of virtual reality training (VRT) and isokinetic training (IKT) in chronic LBP patients. METHODS: Through the simple random sampling method, 60 university football players with chronic LBP were allocated into three groups: NVRT= 20, NIKT= 20 and NCONTROL= 20. The three groups underwent different exercises for 4 weeks. Clinical (pain intensity and kinesiophobia) and hormonal (glucose, insulin, HOMA-IR, growth hormone, prolactin, ACTH and cortisol) values were measured at baseline, after 4 weeks and 6 months. RESULTS: Four weeks following training, the VRT and IKT groups showed significant changes in pain intensity and kinesiophobia in comparison to the control group (p< 0.05). Hormonal measures also showed significant improvement in the VRT group in comparison to the other two groups (p< 0.05). CONCLUSION: Training through virtual reality and isokinetic exercise is an effective approach in terms of pain and kinesiophobia. In terms of hormonal analysis, virtual reality shows slightly more improvements than isokinetic training in subjects with chronic LBP.

Effect of Multi-Modal Therapies for Kinesiophobia Caused by Musculoskeletal Disorders: A Systematic Review and Meta-Analysis

“…After deduplication and applying the exclusion criteria, 12 studies [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] of the total 1042 studies were included for analysis. The flow diagram could be seen in Figure 1 .…”

Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

“…Six studies were conducted in South Korea [26][27][28][29][30][31], one in Brazil [32], one in the USA [33], one in Australia [7], three in Saudi Arabia [34][35][36], one in Turkey [37], and one in Japan [38]. The total number of participants was 765.…”

“…All studies measured pain intensity. It was measured using VAS in nine studies [26][27][28][29]31,[34][35][36]38], 11-point Numeric Pain Rating Scale (11-NPRS) in four studies [7,30,32,37], and The Defense and Veterans Pain Rating Scale (DVPRS) in one study [33]. Four studies measured disability associated with low back pain using the Oswestry Disability Index (ODI) [29][30][31]37], four studies measured kinesiophobia using the 17-item Tampa Scale of Kinesiophobia (17-TSK) [7,35,36,38], and four studies measured body composition using bioelectrical impedance analysis method [27,28,31,38].…”

“…It was measured using VAS in nine studies [26][27][28][29]31,[34][35][36]38], 11-point Numeric Pain Rating Scale (11-NPRS) in four studies [7,30,32,37], and The Defense and Veterans Pain Rating Scale (DVPRS) in one study [33]. Four studies measured disability associated with low back pain using the Oswestry Disability Index (ODI) [29][30][31]37], four studies measured kinesiophobia using the 17-item Tampa Scale of Kinesiophobia (17-TSK) [7,35,36,38], and four studies measured body composition using bioelectrical impedance analysis method [27,28,31,38]. Other variables assessed more frequently were severity of disability with Roland Morris Disability Questionnaire (RMDQ) in two studies [7,30], isokinetic trunk flexion/extension with a dynamometer in three studies [27,28,31], pain self-efficacy with the 10-item Pain Self-Efficacy (10-PSEQ) in two studies [7,38], pain catastrophizing with Pain Catastrophizing Scale (PCS) in two studies [33,38], and blood serum levels of stress hormones in two studies [35,36].…”

“…Variables were assessed before and after the intervention in all articles. Five studies included followup, one at 8 weeks and 6 months [34], other at 3 and 6 months [7], and three only at 6 months [30,35,36]. In addition, one of these studies included a midterm assessment after 4 weeks [30], and one study assessed outcomes during intervention [33].…”