Virtual Reality Program for Managing Chronic Neck Pain

Hacettepe University

Status: Not yet enrolling

Conditions: Chronic Neck Pain

Treatments: Other: Virtual Reality Rehabilitation; Other: Conventional Rehabilitation

Study type: Interventional

Funder types: Other

Identifiers

NCT07189052

VRTR34T

Details and patient eligibility

About

The goal of this clinical trial is to find out if a virtual reality-based rehabilitation program developed by our team can help people with chronic neck pain.

The main questions it aims to answer are:

• Does the VR program reduce neck pain?
• Does it improve daily function and quality of life?

Participants will:

• Take part in a supervised virtual reality exercise program for 8 weeks, attending 3 sessions per week (24 sessions in total).
• Each session will last about 45 minutes.
• Complete tests and questionnaires about their pain, disability, and overall well-being before and after the program.

Full description

This trial evaluates a virtual reality (VR)-based rehabilitation program developed by our team for people with chronic neck pain, compared against conventional therapy (CT) delivered as standard physiotherapy. Both programs share the same exercise components (breathing, stretching, range-of-motion, and posture-strengthening); the VR arm provides a game-adapted version in an immersive "beach and ocean" setting via a head-mounted display. Participants in both arms attend 20-minute sessions, twice per week over the intervention period.  

VR-Based Rehabilitation (Intervention)

The VR treatment module is structured into four components that run continuously within a beach-themed scenario:

• Breathing component: Before gameplay, participants are taught diaphragmatic breathing. In VR, the avatar starts on a deck chair by the sea; on-screen prompts guide the participant to inhale while lifting the head toward the sky and exhale while lowering toward the sand (approx. 5 minutes). 
• Stretching component: The avatar rides a jet-ski along the shoreline and the participant collects coins arranged bilaterally, promoting controlled neck movements within the stretching block. 
• Range-of-motion component: Therapeutic tasks cue cervical flexion, extension, lateral flexion (right/left), and rotation (right/left) as part of the game flow, mirroring the clinical ROM targets. 
• Posture-strengthening component: Gamified tasks reinforce postural and scapular control consistent with the conventional program's strengthening principles. 

Overall, the VR arm delivers the same exercise content as CT, but as a game-adapted version in an immersive beach setting via VR glasses. 

Conventional Therapy (Comparator)

The CT arm performs the same exercise categories as standard, therapist-guided physiotherapy with predefined sets/repetitions:

• Diaphragmatic breathing: 10 repetitions. 
• Stretching: Trapezius (right and left) - 10 repetitions × 15 seconds each side. 
• Neck ROM exercises: Flexion & extension; right/left lateral flexion; right/left rotation - 10 repetitions × 5 seconds per movement. 
• Posture-strengthening: Proprioceptive Neuromuscular Facilitation (PNF)-based scapular retraction - 3 sets × 10 repetitions (with facilitation at the start of each series). 

Dose & schedule: Both arms follow 20-minute sessions, twice weekly; outcomes (e.g., pain, disability, kinesiophobia, quality of life) are recorded pre-/post-intervention (detailed in the Outcomes section).

Enrollment: 32 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-65 years
• Diagnosis of chronic neck pain (≥ 6 months duration)
• Ability to participate in rehabilitation sessions
• Willingness to provide written informed consent

Exclusion criteria

• Previous adverse experience with virtual reality
• Photophobia (UPSIS-12 score > 12)
• Migraine (≥ 2 positive responses on ID-Migraine questionnaire)
• Presence of any neurological deficit
• History of spinal surgery
• Medical conditions interfering with participation, including orthopedic, inflammatory, cardiovascular, rheumatologic, or vestibular disorders
• Pregnancy
• Epilepsy or other neurological conditions causing photosensitivity
• Congenital spinal cord malformations

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

32 participants in 2 patient groups

Virtual Reality Treatment Group

Experimental group

Description:

Participants in this group will receive a virtual reality-based rehabilitation program developed by the investigators for individuals with chronic neck pain. The program includes four structured components: (1) diaphragmatic breathing with guided head movements in a seaside setting; (2) stretching performed through avatar-controlled jet-ski tasks to collect targets; (3) cervical range-of-motion exercises covering flexion, extension, lateral flexion, and rotation; and (4) posture-strengthening tasks to promote scapular and postural control. All exercises correspond to conventional therapy content but are delivered as immersive, game-adapted tasks. The program will be delivered for 8 weeks, 2 sessions per week (16 sessions total), each lasting about 20 minutes.

Treatment:

Other: Virtual Reality Rehabilitation

Conventional Therapy Group

Active Comparator group

Description:

Participants in this group will receive a therapist-guided physiotherapy program for chronic neck pain. The program includes: (1) diaphragmatic breathing, 10 repetitions; (2) trapezius stretching (right and left), 10 repetitions of 15 seconds each; (3) cervical range-of-motion exercises (flexion, extension, lateral flexion, rotation), 10 repetitions of 5 seconds each; and (4) posture-strengthening with proprioceptive neuromuscular facilitation for scapular retraction, 3 sets of 10 repetitions. The program will be delivered for 8 weeks, 2 sessions per week (16 sessions total), each lasting about 20 minutes.

Treatment:

Other: Conventional Rehabilitation