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CTRI Number  CTRI/2025/08/092577 [Registered on: 07/08/2025] Trial Registered Prospectively
Last Modified On: 07/08/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Randomized, Parallel Group, Multiple Arm Trial 
Public Title of Study   Comparing Virtual Reality and Pain neuroscience Education and Regular Physiotherapy for long lasting neck pain without clear cause for pain 
Scientific Title of Study   The short-term effects of virtual reality versus pain neuroscience education versus conventional physiotherapy on pain, kinesiophobia, catastrophizing, and disability in patients with non-specific chronic neck pain 
Trial Acronym  nil 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Kavya C V  
Designation  post graduate student 
Affiliation  SDM college of physiotherapy 
Address  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
Dharwad
KARNATAKA
580009
India 
Phone  8197905683  
Fax    
Email  kavyacv73222@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Kavya C V  
Designation  post graduate student 
Affiliation  SDM college of physiotherapy 
Address  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
Dharwad
KARNATAKA
580009
India 
Phone  8197905683  
Fax    
Email  kavyacv73222@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr Sweta Kulkarni 
Designation  professor and PG Guide 
Affiliation  SDM college of physiotherapy 
Address  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
Dharwad
KARNATAKA
580009
India 
Phone  9886276543  
Fax    
Email  dr.shweta07@gmail.com  
 
Source of Monetary or Material Support  
SDM college of medical science and hospital, SDM college of physiotherapy, manjushree nagar, sattur, dharwad - 580009 india 
 
Primary Sponsor  
Name  Kavya C V  
Address  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009 
Type of Sponsor  Other [self] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 2  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Kavya C V   SDM college of physiotherapy  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
Dharwad
KARNATAKA 
8197905683

kavyacv73222@gmail.com 
Dr Sweta Kulkarni  SDM college of physiotherapy  OPD No 5, orthopedic physiotherapy department, SDM college of physiotherapy, SDM college of medical science and hospital,manjushree nagar sattur, dharwad 580009
Dharwad
KARNATAKA 
9886276543

dr.shweta07@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
SDM COLLEGE OF MEDICAL SCIENCES AND HOSPITAL  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M542||Cervicalgia,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Group A - Virtual reality and exercises  Participants in the Virtual Reality (VR) group will undergo VR-based rehabilitation combined with therapeutic exercises. Each session will begin with an orientation to ensure safe and proper use of the VR device. Participants will engage in VR activities such as interactive games (e.g., roller coaster or racing games) designed to encourage neck movement in multiple directions. These activities will be performed in a seated position and controlled by head and neck movements (flexion, extension, lateral rotation). Each VR session will last for approximately 10–15 minutes, twice a week for 4 weeks. In addition, participants will be prescribed a home exercise program including chin tucks, cervical range of motion exercises, scapular retraction, and deep neck flexor activation to be performed daily. 
Intervention  Group B - Pain neuroscience education and exercises   Participants in this group will receive education on neurobiology and neurophysiology of pain, emphasizing the concept that pain is not always a sign of tissue damage but a protective response by the nervous system. Education will be provided using pamphlets, metaphors, and examples from the book Explain Pain by Butler and Moseley. Graded Motor Imagery will be introduced, including left/right discrimination and explicit motor imagery tasks using the Recognise™ app. PNE sessions will be supplemented with a home exercise program (chin tucks, cervical ROM, scapular retraction, deep neck flexor activation) to be performed daily for 4 weeks. 
Comparator Agent  Group C - CONVENTIONAL PHYSIOTHERAPY  Participants in this group will undergo traditional physiotherapy focusing on cervical mobility, strengthening, and postural correction exercises. Sessions will progress weekly from basic exercises (chin tucks, cervical ROM, scapular retraction) to advanced strengthening and functional tasks (isometric neck strengthening, scapular wall slides, resisted neck movements with elastic bands). Each session will last 45–60 minutes, twice a week for 4 weeks. A similar exercise program will be prescribed as a home program for daily practice. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1) Subjects having neck pain more than 12 weeks or 3months.
2) Age group of 18 to 65 years
3) VAS more than 3
4) TSK-17 score more than 17
5) PCS more than 30
6) NDI more than or equal to 15

 
 
ExclusionCriteria 
Details  1) Severe cervical instability or recent trauma
2) Vertigo or vestibular disorders
3) Severe motion sickness
4) Active cervicogenic headache or migraines
5) Visual or speech or hearing impairments
6) Pregnancy.
7) Unwilling to participate voluntarily
8) Suspected cervical spinal pathology like-malignancies, Unhealed vertebral fractures, ankylosing spondylitis, Inflammatory arthritis.
9) Cervical radiculopathy
 
 
Method of Generating Random Sequence   Stratified block randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant and Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
1) VAS
2) Tampa scale of kinesiophobia 17
3) Pain catastrophizing scale
4) Pain pressure threshold – aesthsiometer
5) Neck disability index scale
 
1) VAS - baseline and 4th week
2) Tampa scale of kinesiophobia 17 - baseline and 4th week
3) Pain catastrophizing scale - baseline and 4th week
4) Pain pressure threshold – aesthsiometer - baseline and 4th week
5) Neck disability index scale - baseline and 4th week
 
 
Secondary Outcome  
Outcome  TimePoints 
Neck Range of motion   Neck Range of motion - baseline and 4th week 
 
Target Sample Size   Total Sample Size="81"
Sample Size from India="81" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 2/ Phase 3 
Date of First Enrollment (India)   01/09/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  
This study is a randomized controlled trial investigates the short-term effects of three physiotherapy approaches Virtual Reality (VR), Pain Neuroscience Education (PNE), and conventional physiotherapy on individuals with non-specific chronic neck pain, focusing on outcomes like pain intensity, kinesiophobia, catastrophizing, and disability. Chronic neck pain is a growing health issue, especially in India, due to poor postural habits, prolonged digital device use, and sedentary lifestyles. Despite a surge in technological advancements like VR and increased interest in educational approaches such as PNE, most existing research is based in high-income nations and lacks contextual relevance to Indian populations. The study recognizes the importance of understanding psychological contributors to chronic pain, particularly fear of movement and catastrophic thinking, which are often neglected in conventional protocols. The trial includes 81 subjects aged 18–65 years, divided into three groups Group A (VR-based therapy + exercise), Group B (PNE + exercise), and Group C (conventional therapy). Pain will be measured using the Visual Analogue Scale (VAS) and Pain Pressure Threshold, kinesiophobia with the Tampa Scale (TSK-17), catastrophizing with the Pain Catastrophizing Scale (PCS), and disability with the Neck Disability Index (NDI). Each group follows a structured 4-week  treatment plan, with outcome measures assessed at baseline and after completion. VR therapy aims to reduce pain through distraction and multisensory engagement. PNE seeks to shift the patient’s understanding of pain from a tissue-damage focus to a central nervous system perspective using metaphors and cognitive tools. Conventional therapy emphasizes structured exercise progression with heat application. Previous literature supports the benefits of all three interventions, yet comparative studies remain sparse. This research aims to fill that gap by providing India-specific evidence on efficacy and feasibility. If proven effective, VR and PNE may offer cost-effective, scalable alternatives for physiotherapy delivery, especially in underserved rural settings. Ethical clearance and informed consent will be obtained prior to enrollment. The findings are expected to aid clinicians in choosing effective, personalized interventions for managing chronic neck pain and may significantly improve the quality of life in affected individuals while reducing healthcare burden through innovative, accessible care models.

 
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