Focus of attention during virtual-reality core exercises for older adults with chronic low back pain

Comparison of External and Internal Focus of Attention in Virtual Reality-Based Exercise Training in Older Adults With Chronic Low Back Pain: A Randomized Controlled Trial

Not applicable Interventional Kirsehir Ahi Evran Universitesi · NCT07414017

This trial will test whether telling older adults with chronic low back pain to focus on external cues versus internal body sensations during virtual-reality core exercises helps improve balance, strength, frailty, and mood.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment40 (estimated)
Ages65 Years to 80 Years
SexAll
SponsorKirsehir Ahi Evran Universitesi Academic / other
Locations1 site (Center, Kirşehi̇r)
Trial IDNCT07414017 on ClinicalTrials.gov

What this trial studies

Older adults (≥65) with non-specific chronic low back pain will be recruited at Kırşehir Ahi Evran University Hospital and screened for eligibility including cognitive and sensory function. Eligible participants will be randomized to receive virtual reality–based core stabilization exercises with either external-focus or internal-focus instructions, with a traditional treatment program included as a comparator. Outcomes include measures of frailty, balance, fall risk, lower-extremity functional strength, sarcopenia risk, and depressive symptoms measured before and after the intervention period. The intervention uses interactive virtual-reality exercises delivered by physiotherapists with standardized attentional-focus cues and pre- and post-intervention assessments.

Who should consider this trial

Good fit: Community-dwelling adults aged 65 or older with non-specific chronic low back pain for at least three months who can walk and perform most daily activities independently and have adequate cognition (MMSE ≥ 24).

Not a fit: Patients with specific structural causes of back pain, recent lumbar or lower-extremity surgery, severe neurological disorders, or major uncorrected sensory impairments are unlikely to benefit or be eligible for this program.

Why it matters

Potential benefit: If successful, this approach could reduce fall risk and improve balance, strength, and frailty-related outcomes in older adults with chronic low back pain.

How similar studies have performed: Previous research suggests external-focus instructions and virtual-reality rehabilitation can improve motor learning and balance, but evidence specifically in older adults with chronic low back pain is limited and results have been mixed.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Aged 65 years and older
* Diagnosis of non-specific chronic low back pain lasting at least 3 months
* Ability to stand and walk independently (use of assistive devices such as a cane or walker is permitted)
* Ability to perform most activities of daily living independently
* No severe visual, auditory, or vestibular impairments that would prevent participation in a virtual reality-based exercise program
* Adequate cognitive function to understand and follow instructions (Mini-Mental -State Examination score ≥ 24 or clinical judgment)
* Willingness to participate in the study and provision of written informed consent

Exclusion Criteria:

* Presence of specific causes of low back pain (e.g., vertebral fracture, tumor, infection, inflammatory rheumatic diseases, advanced spinal stenosis, spondylolisthesis)
* History of lumbar spine or lower extremity surgery within the past 6 months
* Presence of severe neurological disorders (e.g., stroke, Parkinson's disease, multiple sclerosis) or severe peripheral neuropathy
* Uncontrolled cardiovascular, respiratory, or metabolic diseases that may pose a risk during exercise participation
* Any acute medical condition or musculoskeletal disorder that contraindicates participation in exercise training

Where this trial is running

Center, Kirşehi̇r

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Focus of AttentionGeriartricsChronic low back pain.External focus of attentionInternal focus of attention
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.