The effect of virtual reality training on pain and postural control in elderly men with chronic nonspecific low back pain: a randomized, double-blind clinical trial

Document Type : Research Paper

Authors

1 department of sport rehabilitation, faculty of sport sciences, bu-ali sina university

2 Department of sport rehabilitation, Faculty of sport sciences, Bu-ali Sina university

3 Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Arak University

4 Department of Sports Science, Bu Ali Sina University, Faculty of Physical Education

Abstract

Background and Aim: Chronic musculoskeletal pain increases significantly with age. Back pain is the most common pain reported by elderly people in the world. Virtual reality (VR) technology has become increasingly prevalent in many spheres of knowledge, including healthcare rehabilitation. The aim of this study was to determine the effect of eight weeks of virtual reality training (VRT) on pain and postural control of elderly men with chronic nonspecific low back pain (CNLBP).
Methods: Thirty elderly patients with CNLBP in both experimental and control groups participated in this study. The experimental group performed 30 min VRT three times a week for eight weeks, and the control group continued their normal life routine during this period. Pain and center of pressure (CoP) variable were assessed before and after the intervention using visual analogue scale and foot pressure system, respectively. Paired sample t-test and one way analysis of covariance at SPSS software version 22 were used for data analysis (P<0.05).
Results: The results of statistical analysis indicated that pain (P=0.001) and CoP variables (oscillation velocity (P=0.014), sway area (P=0.004), anterior-posterior displacement (P=0.000) and medial-lateral displacement (P=0.03)) in the experimental group had a significant decrease compared to the control after eight weeks.
Conclusion: According to the obtained results, the use of VRT with the aim of reducing pain and postural fluctuations is recommended to rehabilitation of geriatric with CNLBP.

Keywords

Main Subjects

References

Ahmadpour, N., Keep, M., Janssen, A., Rouf, A. S., & Marthick, M. (2020). “Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review”. JMIR Serious Games, 8(1). https://doi.org/10.2196/14565
Alsufiany, M. B., Lohman, E. B., Daher, N. S., Gang, G. R., Shallan, A. I., & Jaber, H. M. (2020). “Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study”. Medicine, 99(5), e18544. https://doi.org/10.1097/MD.0000000000018544
Aoki, Y., Sugiura, S., Nakagawa, K., Nakajima, A., Takahashi, H., Ohtori, S., Takahashi, K., & Nishikawa, S. (2012). “Evaluation of nonspecific low back pain using a new detailed visual analogue scale for patients in motion, standing, and sitting: characterizing nonspecific low back pain in elderly patients”. Pain Research and Treatment, 2012. https://doi.org/10.1155/2012/680496
Armstrong, K., Gokal, R., Chevalier, A., Todorsky, W., & Lim, M. (2017). “Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain”. Journal of Alternative and Complementary Medicine (New York, N.Y.), 23(4), 295–299. https://doi.org/10.1089/ACM.2016.0313
Bacha, J. M. R., Gomes, G. C. V., de Freitas, T. B., Viveiro, L. A. P., da Silva, K. G., Bueno, G. C., Varise, E. M., Torriani-Pasin, C., Alonso, A. C., Luna, N. M. S., D’andrea Greve, J. M., & Pompeu, J. E. (2018). “Effects of Kinect Adventures Games Versus Conventional Physical Therapy on Postural Control in Elderly People: A Randomized Controlled Trial”. Games for Health Journal, 7(1), 24–36. https://doi.org/10.1089/G4H.2017.0065
Bae, Y. (2020). “Comparison of Postural Sway, Plantar Cutaneous Sensation According to Saccadic Eye Movement Frequency in Young Adults”. International Journal of Environmental Research and Public Health, 17(19), 1–8. https://doi.org/10.3390/IJERPH17197067
Barbieri, F. A., & Vitório, R. (2017). “Locomotion and Posture in Older Adults: The Role of Aging and Movement Disorders”. Locomotion and Posture in Older Adults: The Role of Aging and Movement Disorders, 1-457. https://doi.org/10.1007/978-3-319- 48980-3
Bieryla, K. A., & Dold, N. M. (2013). “Feasibility of Wii Fit training to improve clinical measures of balance in older adults”. Clinical Interventions in Aging, 8, 775–781. https://doi.org/10.2147/CIA. S46164
Bisson, E., Contant, B., Sveistrup, H., & Lajoie, Y. (2007). “Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training”. Cyberpsychology & Behavior : The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 10(1), 16–23. https://doi.org/10.1089/CPB.2006.9997
Cameron, E. J., Bowles, S. K., Marshall, E. G., & Andrew, M. K. (2018). “Falls and long-term care: a report from the care by design observational cohort study”. BMC Family Practice, 19(1). https://doi.org/10.1186/S12875-018-0741-6
Chiarovano, E., Wang, W., Rogers, S. J., MacDougall, H. G., Curthoys, I. S., & de Waele, C. (2017). “Balance in Virtual Reality: Effect of Age and Bilateral Vestibular Loss”. Frontiers in Neurology, 8(JAN). https://doi.org/10.3389/FNEUR.2017.00005
Costa, M. T. S., Vieira, L. P., Barbosa, E. de O., Mendes Oliveira, L., Maillot, P., Otero Vaghetti, C. A., Giovani Carta, M., Machado, S., Gatica-Rojas, V., & Monteiro-Junior, R. S. (2019). “Virtual Reality-Based Exercise with Exergames as Medicine in Different Contexts: A Short Review”. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 15(1), 15–20. https://doi.org/10.2174/1745017901915010015
De Amorim, J. S. C., Leite, R. C., Brizola, R., & Yonamine, C. Y. (2018). “Virtual reality therapy for rehabilitation of balance in the elderly: a systematic review and META-analysis”. Advances in Rheumatology (London, England), 58(1), 18. https://doi.org/10.1186/S42358-018-0013-0
Ditchburn, J. L., van Schaik, P., Dixon, J., MacSween, A., & Martin, D. (2020). “The effects of exergaming on pain, postural control, technology acceptance and flow experience in older people with chronic musculoskeletal pain: a randomised controlled trial”. BMC Sports Science, Medicine & Rehabilitation, 12(1). https://doi.org/10.1186/ S13102-020-00211-X
Gholami Borujeni, B., & Yalfani, A. (2019). “Correlation of pain and lumbar arch with electromyography of ankle muscle in athletes with low back pain”. Anesthesiology and Pain, 10(3), 105 -118.
Gholami Borujeni, B., & Yalfani, A. (2019). “Reduction of postural sway in athletes with chronic low back pain through eight weeks of inspiratory muscle training: A randomized controlled trial”. Clinical biomechanics (Bristol, Avon), 69, 215–220.
Gholami Borujeni B., & Yalfani A. (2019). “Immediate Effect of Respiratory Muscle Sprint-Interval Training (RMSIT) on the Plantar Pressure Variables in Athletes with Chronic Low Back Pain: A Randomized Controlled Trial”. Iranian Rehabilitation Journal, 17 (3) :271-278.
Gholami Borujeni, B., Yalfani, A. (2019). “Postural Control and Plantar Pressure Symmetry in Male and Female Athletes With Chronic Low Back Pain When Performing Overhead Squat”. Journal of Kerman University of Medical Sciences, 26(4), 307-315. doi: 10.22062/jkmu.2019.89524.
Gold, J. I., Belmont, K. A., & Thomas, D. A. (2007). “The neurobiology of virtual reality pain attenuation”. Cyberpsychology & Behavior : The Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society, 10(4), 536–544. https://doi.org/10.1089/CPB.2007.9993
Goossens, N., Janssens, L., Caeyenberghs, K., Albouy, G., & Brumagne, S. (2019). “Differences in brain processing of proprioception related to postural control in patients with recurrent non-specific low back pain and healthy controls”. NeuroImage. Clinical, 23. https://doi.org/10.1016/J.NICL. 2019.101881
Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). “Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)”. Arthritis Care & Research, 63 Suppl 11 (SUPPL. 11). https://doi.org/10.1002/ ACR.20543
Htut, T. Z. C., Hiengkaew, V., Jalayondeja, C., & Vongsirinavarat, M. (2018). “Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial”. European Review of Aging and Physical Activity : Official Journal of the European Group for Research into Elderly and Physical Activity, 15(1). https://doi.org/10.1186/S11556-018-0199-5
Jones, S. L., Henry, S. M., Raasch, C. C., Hitt, J. R., & Bunn, J. Y. (2012). “Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture”. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 22(1), 13–20. https://doi.org/10.1016/J.JELEKIN.2011.10.006
Kamińska, M. S., Miller, A., Rotter, I., Szylińska, A., & Grochans, E. (2018). “The effectiveness of virtual reality training in reducing the risk of falls among elderly people”. Clinical Interventions in Aging, 13, 2329–2338. https://doi.org/10.2147/ CIA.S183502
Karahan, A. Y., Tok, F., Taşkın, H., Küçüksaraç, S., Başaran, A., & Yildirim, P. (2015). “Effects of Exergames on Balance, Functional Mobility, and Quality of Life of Geriatrics Versus Home Exercise Programme: Randomized Controlled Study”. Central European Journal of Public Health, 23 Suppl, S14–S18. https://doi.org/10.21101/CEJPH. A4081
Kiaghadi, A., Bahramizadeh, M., & Hadadi, M. (2020). “Effect of Textured and Prefabricated Insole Use With Medical or Sports Shoes on Dynamic Postural Control in Elderly People”. Topics in Geriatric Rehabilitation,36(1), 55-59.
Kim, S.-S., Min, W.-K., Kim, J.-H., & Lee, B.-H. (2014). “The Effects of VR-based Wii Fit Yoga on Physical Function in Middle-aged Female LBP Patients”. Journal of Physical Therapy Science, 26(4), 549. https://doi.org/10.1589/JPTS.26.549
Kitayuguchi, J., Kamada, M., Inoue, S., Kamioka, H., Abe, T., Okada, S., & Mutoh, Y. (2017). “Association of low back and knee pain with falls in Japanese community-dwelling older adults: A 3-year prospective cohort study”. Geriatrics & Gerontology International, 17(6), 875–884. https://doi.org/10.1111/GGI.12799
Lihavainen, K., Sipilä, S., Rantanen, T., Sihvonen, S., Sulkava, R., & Hartikainen, S. (2010). “Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older”. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 65(9), 990–996. https://doi.org/10.1093/ GERONA/GLQ052
Makris, U. E., Fraenkel, L., Han, L., Leo-Summers, L., & Gill, T. M. (2014). “Risk factors for restricting back pain in older persons”. Journal of the American Medical Directors Association, 15(1), 62–67. https://doi.org/10.1016/J.JAMDA.2013.09. 013
Malfliet, A., Ickmans, K., Huysmans, E., Coppieters, I., Willaert, W., van Bogaert, W., Rheel, E., Bilterys, T., van Wilgen, P., & Nijs, J. (2019). “Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain”. Journal of Clinical Medicine, 8(7). https://doi.org/10.3390/ JCM8071063
Matheve, T., Bogaerts, K., & Timmermans, A. (2020). “Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial”. Journal of Neuroengineering and Rehabilitation, 17(1). https://doi.org/10.1186/ S12984- 020-00688-0
Nagymáté, G., Orlovits, Z., & Kiss, R. M. (2018). “Reliability analysis of a sensitive and independent stabilometry parameter set”. PloS One, 13(4). https://doi.org/10.1371/JOURNAL.PONE.0195995
Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda-Sceppa, C. (2007). “Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association”. Medicine and Science in Sports and Exercise, 39(8), 1435–1445. https://doi.org/10.1249/MSS.0B013E3180616AA2
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavy, D. L. (2020). “Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis”. British Journal of Sports Medicine, 54(21), 1279–1287. https://doi.org/10.1136/ BJSPORTS -2019-100886
Paolucci, T., Attanasi, C., Cecchini, W., Marazzi, A., Capobianco, S. v., & Santilli, V. (2018). “Chronic low back pain and postural rehabilitation exercise: a literature review”. Journal of Pain Research, 12, 95–107. https://doi.org/10.2147/JPR.S171729
Park, D. S., Lee, D. G., Lee, K., & Lee, G. C. (2017). “Effects of Virtual Reality Training using Xbox Kinect on Motor Function in Stroke Survivors: A Preliminary Study”. Journal of Stroke and Cerebrovascular Diseases : The Official Journal of National Stroke Association, 26(10), 2313–2319. https://doi.org/10.1016/J.JSTROKECEREBROVASDIS.2017.05.019
Park, J., Lee, D., & Lee, S. (2014). “Effect of Virtual Reality Exercise Using the Nintendo Wii Fit on Muscle Activities of the Trunk and Lower Extremities of Normal Adults”. Journal of Physical Therapy Science, 26(2), 271. https://doi.org/10. 1589/JPTS.26.271
Pourmand, A., Davis, S., Marchak, A., Whiteside, T., & Sikka, N. (2018). “Virtual Reality as a Clinical Tool for Pain Management”. Current Pain and Headache Reports, 22(8). https://doi.org/10.1007/ S11916-018-0708-2
Qazi, S. L., Sirola, J., Kröger, H., Honkanen, R., Isanejad, M., Airaksinen, O., & Rikkonen, T. (2019). “High Postural Sway Is an Independent Risk Factor for Osteoporotic Fractures but Not for Mortality in Elderly Women”. Journal of Bone and Mineral Research : The Official Journal of the American Society for Bone and Mineral Research, 34(5), 817–824. https://doi.org/10.1002/JBMR. 3664
Schättin, A., Arner, R., Gennaro, F., & de Bruin, E. D. (2016). “Adaptations of Prefrontal Brain Activity, Executive Functions, and Gait in Healthy Elderly Following Exergame and Balance Training: A Randomized-Controlled Study”. Frontiers in Aging Neuroscience, 8(NOV). https://doi.org/10.3389/ FNAGI.2016.00278
Serino, S., Pedroli, E., Keizer, A., Triberti, S., Dakanalis, A., Pallavicini, F., Chirico, A., & Riva, G. (2016). “Virtual Reality Body Swapping: A Tool for Modifying the Allocentric Memory of the Body”. Cyberpsychology, Behavior and Social Networking, 19(2), 127–133. https://doi.org/10. 1089/CYBER.2015.0229
Sharar, S. R., Miller, W., Teeley, A., Soltani, M., Hoffman, H. G., Jensen, M. P., & Patterson, D. R. (2008). “Applications of virtual reality for pain management in burn-injured patients”. Expert Review of Neurotherapeutics, 8(11), 1667–1674. https://doi.org/10.1586/14737175.8.11.1667
Singh, D. K. A., Rajaratnam, B. S., Palaniswamy, V., Pearson, H., Raman, V. P., & Bong, P. S. (2012). “Participating in a virtual reality balance exercise program can reduce risk and fear of falls”. Maturitas, 73(3), 239–243. https://doi.org/10.1016/J.MATURITAS.2012.07.011.
Smith, B., Claiborne, T., & Liberi, V. (2016). “Ankle bracing decreases vertical jump height and alters lower extremity kinematics”. International Journal of Athletic Therapy and Training. https://doi.org/10.1123/ijatt.2014-0143
Soliman, E. S., Shousha, T. M., & Alayat, M. S. (2017). “The effect of pain severity on postural stability and dynamic limits of stability in chronic low back pain”. Journal of Back and Musculoskeletal Rehabilitation, 30(5), 1023–1029. https://doi.org/10.3233/BMR-169588
Stamm, O., Dahms, R., & Müller-Werdan, U. (2020). “Virtual reality in pain therapy: a requirements analysis for older adults with chronic back pain”. Journal of NeuroEngineering and Rehabilitation, 17(1). https://doi.org/10.1186/S12984-020-00753-8
Stanton, Alice E, Xinming Tong, and Fan Yang. 2019. “Extracellular Matrix Type Modulates Mechanotransduction of Stem Cells”. Acta biomaterialia 96: 310–20.
Svoboda, Z., Bizovska, L., Gonosova, Z., Linduska, P., Kovacikova, Z., & Vuillerme, N. (2019). “Effect of aging on the association between ankle muscle strength and the control of bipedal stance”. PloS One, 14(10). https://doi.org/10.1371/JOURNAL. PONE.0223434
Trost, Z., Zielke, M., Guck, A., Nowlin, L., Zakhidov, D., France, C. R., & Keefe, F. (2015). “The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain”. Pain Management, 5(3), 197–206. https://doi.org/10.2217/PMT.15.6
Turner, A. J., Chander, H., & Knight, A. C. (2018). “Falls in Geriatric Populations and Hydrotherapy as an Intervention: A Brief Review”. Geriatrics (Basel, Switzerland), 3(4). https://doi.org/10.3390/ GERIATRICS3040071
Virk, S., & Valter McConville, K. M. (2006). “Virtual reality applications in improving postural control and minimizing falls”. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2006, 2694–2697. https://doi.org/10.1109/IEMBS.2006.260751
Wu J, Loprinzi PD, Ren Z. (2019). “The Rehabilitative Effects of Virtual Reality Games on Balance Performance among Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials”. International journal of environmental research and public health. 2019 Jan; 16(21): 4161.
Yalfani, A., & Raeisi, Z. (2021). “Prophylactic ankle supports effects on time to stabilization, perceived stability and ground reaction force during lateral landing in female collegiate athletes with chronic ankle instability”. BMC Sports Science, Medicine and Rehabilitation 2021 13:1, 13(1), 1–9. https://doi.org/10.1186/S13102-021-00291-3.
 

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