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Trial registered on ANZCTR
Registration number
ACTRN12624000254594
Ethics application status
Approved
Date submitted
12/01/2024
Date registered
14/03/2024
Date last updated
14/07/2024
Date data sharing statement initially provided
14/03/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating the role of Immersive Virtual Reality mindfulness in mitigating acute exercise-induced pain following exercise in chronic low back pain: a feasibility randomized controlled trial
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Scientific title
Evaluating the role of Immersive Virtual Reality mindfulness in mitigating acute exercise-induced pain following exercise in chronic low back pain: a feasibility randomized controlled trial
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Secondary ID [1]
311310
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NIL known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic low back pain
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Condition category
Condition code
Musculoskeletal
329262
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will take place immediately following completion of the routinely physical exercise class. The routinely physical exercise class is part of a conservative management for patients referred for surgical considerations of their low back pain. The exercise class is conducted in a gym setting with up to 8 individuals. Attendees are provided with an individualised program that may include a combination of strength, mobility, movement control, and/or cardiovascular fitness. Individuals are generally referred to once weekly sessions for six weeks, with each session lasting 45-60 minutes. For the intervention, participants undertaking virtual reality mindfulness (VRM) will be familiarized with the virtual reality headset, before undertaking a single, 10-15-minute mindfulness/meditation intervention. We will use the Guided Meditation VR (Meta) as the virtual reality software application. The use of virtual reality headset and chosen software application allows for an immersive setting in a calm and naturalistic environment with an oral guided mindfulness session. As part of the intervention, individuals will be guided through a series of mindfulness/meditation exercises, including breathing exercisers, body scans, and acceptance of emotions and thoughts. The participants will be asked to follow the guided mindfulness instructions. Participants can elect to complete the VRM in either a seated or supine position. The intervention will consist of a single session following their routinely physical exercise class. The intervention will be administered by a qualified member of the research staff. Adherence will be monitored by direct supervision by the administering research staff.
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Intervention code [1]
327760
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Treatment: Devices
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Comparator / control treatment
Usual post-exercise management (i.e., no specific intervention) where attendees are instructed to monitor their symptoms following the exercise session, and to contact the treating physiotherapist if they experience a significant exacerbation of their symptoms.
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Control group
Active
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Outcomes
Primary outcome [1]
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Current pain level
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Assessment method [1]
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11-point numerical scale (0-10), anchored by ‘no pain’ (0) and ‘pain as bad as it could be’ (10).
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Timepoint [1]
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Average pain level (over the preceding 7 days) and current pain level will be measured immediately pre-exercised class.
Current pain levels will be measured post completion of exercise class.
Current pain levels will be measured at 15 min, 1-hour, 3-hour, 6/24-hour, 2-, 3-, and 4-days post-completion of mindfulness intervention.
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Secondary outcome [1]
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Feasibility of the intervention
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Assessment method [1]
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Recruitment (including potentially eligible and eligible, invited, and consented rates)
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Timepoint [1]
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Upon conclusion of the study (4-days post-completion of mindfulness intervention following completion of data collection).
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Secondary outcome [2]
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Acceptability of the intervention
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Assessment method [2]
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Via a 5-item open-ended survey that has been specifically designed for this study to evaluate the participants acceptability of the intervention.
Only participants allocated to the virtual reality mindfulness arm will be administered the survey
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Timepoint [2]
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Will be administered immediately following completion of mindfulness intervention.
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Secondary outcome [3]
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Feasibility of the intervention
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Assessment method [3]
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Intervention fidelity
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Timepoint [3]
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Upon conclusion of the study (4-days post-completion of mindfulness intervention following completion of data collection).
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Secondary outcome [4]
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Feasibility of the intervention
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Assessment method [4]
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Intervention adherence (participant completed outcome measures, text response rates)
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Timepoint [4]
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Upon conclusion of the study (4-days post-completion of mindfulness intervention following completion of data collection).
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Secondary outcome [5]
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Simulator Sickness
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Assessment method [5]
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Simulator sickness will be measured by the Simulator Sickness Questionnaire.
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Timepoint [5]
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Will be administered immediately following the intervention
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Eligibility
Key inclusion criteria
Individuals will be eligible if they have had low back pain for a minimum of 3 months, access to a mobile phone for SMS, a minimum of 3 on an 11-point numeric scale, at least moderate chronic low back pain related disability, and currently part of clinic-based physiotherapy exercise program for their chronic low back pain.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria for the participants includes severe vertigo, severe susceptibility to motion sickness, current use of VRM, visually impaired to the degree they can’t use the VRM as intended, pregnancy, back pain of a non-musculoskeletal cause, severe neurological deficit, or symptoms (e.g., cauda equina syndrome, myelopathy, or evidence of nerve root compromise), use of medical analgesics, or insufficient understanding of English and inability to follow directions and instructions.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation. . The block randomization procedure will be to allocate participants to blocks with a block size of 4 with 6 different allocations combinations with 2 control and 2 treatments
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
10/07/2024
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Actual
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Date of last participant enrolment
Anticipated
12/08/2024
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Actual
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Date of last data collection
Anticipated
16/08/2024
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Actual
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Sample size
Target
48
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Accrual to date
0
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Royal Brisbane & Womens Hospital - Herston
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Recruitment hospital [2]
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North Lakes Health Precinct - North Lakes
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Recruitment postcode(s) [1]
42841
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4029 - Herston
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Recruitment postcode(s) [2]
42842
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4509 - North Lakes
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Queensland - RECOVER Research and Injury Centre
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Address [1]
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296 Herston Rd, Herston QLD 4029
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Queensland
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Address
Block 20 Royal Brisbane and Women’s Hospital, Butter??eld St, Herston QLD 4006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
317658
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Country [1]
317658
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Metro North Health Human Research Ethics Committee B
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Ethics committee address [1]
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MetroNorthResearch-Ethics@health.qld.gov.au
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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29/11/2023
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Approval date [1]
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06/02/2024
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Ethics approval number [1]
314464
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104407 Approval
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Summary
Brief summary
Management of chronic low back pain is challenging, and current best evidence recommends incorporating physiotherapeutic exercise training. Despite this, physical exercise can lead to flare up in pain immediately following exercise and over the subsequent days in individuals with chronic pain. Virtual reality (VR) is a novel emerging technology that is increasingly being used in pain rehabilitation with demonstrated effectiveness in decreasing pain. One application of VR that has received relatively little attention to date in the management of chronic pain is virtual reality mindfulness/meditation (VRM). VRM offers a novel approach to addressing chronic pain as it can create a calming and relaxing setting that facilitates practicing mindfulness skills, with demonstrated effects. This study investigates if VRM has a positive effect on reducing exacerbation of pain following exercise among individuals with chronic low back pain. We hypothesise that the VRM intervention will reduce immediate and laten pain levels compared to controls undertaking usual post-exercise management as well as the VRM is tolerated with minimal side effects and is feasible and acceptable.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Trevor Russell
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Address
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RECOVER INJURY RESEARCH CENTRE, 296 Herston Rd, Herston QLD 4029
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Country
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Australia
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Phone
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+61 7 3365 5560
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Trevor Russell
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Address
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RECOVER INJURY RESEARCH CENTRE, 296 Herston Rd, Herston QLD 4029
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Country
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Australia
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Phone
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+61 7 3365 5560
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Trevor Russell
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Address
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RECOVER INJURY RESEARCH CENTRE, 296 Herston Rd, Herston QLD 4029
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Country
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Australia
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Phone
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+61 7 3365 5560
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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