{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:01:50Z","timestamp":1764219710519,"version":"3.46.0"},"reference-count":26,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"DRCI SAM CHU Angers"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,21]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic low back pain (CLBP) is a leading cause of disability worldwide, significantly affecting patients\u2019 quality of life. Functional restoration programmes (FRPs) are recommended to improve functional abilities and alleviate kinesiophobia, but the integration of emerging technologies like immersive virtual reality (VR) remains underexplored. VR has shown potential in reducing pain and enhancing motor imagery (MI), but its application in group-based rehabilitation for CLBP is novel. This study protocol aims to assess the feasibility and acceptability of adding immersive VR to multicentre FRPs for CLBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This multicentric, prospective, single-arm exploratory pilot study assesses the acceptance of incorporating an immersive VR headset into FRP for patients with CLBP. Participants will include healthcare providers and patients from centres in the Lombaction network. Patients will engage in standard FRP alongside three\u2009weekly VR sessions targeting trunk mobility and pain reduction. The primary objective is to evaluate the acceptance of the VR device among healthcare providers and patients (Unified Theory of Acceptance and Use of Technology 2-based questionnaire). Secondary outcomes include acceptability, usability (System Usability Scale), adherence, safety and effects on kinesiophobia, MI, pain levels and functional capacities. Data collection includes baseline and post-intervention questionnaires, adherence monitoring and standardised scales (eg, Tampa Scale for Kinesiophobia, Dallas Pain Questionnaire).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was granted by Comit\u00e9 de Protection des Personnes Sud-Est VI on 10 January 2025; all participants will provide written informed consent. Results will be disseminated through peer-reviewed publications, conference presentations and summaries to participating centres.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06724679\">NCT06724679<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106366","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T03:50:35Z","timestamp":1764215435000},"page":"e106366","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Study protocol: use of virtual reality in a functional restoration programme for the spine\u2014single-arm acceptance study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06724679","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06724679","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7495-3638","authenticated-orcid":false,"given":"Romain","family":"Champagne","sequence":"first","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Laval Hospital, Laval, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Ali","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Angers University Hospital, Angers, Pays de la Loire, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoann","family":"Ronzi","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Les Capucins R\u00e9adaptation Sp\u00e9cialis\u00e9e et Soins de Longue Dur\u00e9e, Angers, Pays de la Loire, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mickael","family":"Dinomais","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Angers University Hospital, Angers, Pays de la Loire, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2025112619502274000_15.11.e106366.1","doi-asserted-by":"crossref","first-page":"2384","DOI":"10.1016\/S0140-6736(18)30488-4","article-title":"Low back pain: a call for action","volume":"391","author":"Buchbinder","year":"2018","journal-title":"The Lancet"},{"key":"2025112619502274000_15.11.e106366.2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001869"},{"key":"2025112619502274000_15.11.e106366.3","unstructured":"Haute autorit\u00e9 de sant\u00e9 . Prise en charge du patient pr\u00e9sentant une lombalgie commune. 2019."},{"key":"2025112619502274000_15.11.e106366.4","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.annrmp.2007.04.010","article-title":"Int\u00e9r\u00eats du r\u00e9entra\u00eenement \u00e0 l\u2019effort dans la lombalgie : le concept de restauration fonctionnelle","volume":"50","author":"Poiraudeau","year":"2007","journal-title":"Annales de R\u00e9adaptation et de M\u00e9decine Physique"},{"key":"2025112619502274000_15.11.e106366.5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jpain.2012.09.007","article-title":"The effects of graded motor imagery and its components on chronic pain: a systematic review and meta-analysis","volume":"14","author":"Bowering","year":"2013","journal-title":"J Pain"},{"key":"2025112619502274000_15.11.e106366.6","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1016\/S0140-6736(23)00441-5","article-title":"Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial","volume":"401","author":"Kent","year":"2023","journal-title":"The Lancet"},{"key":"2025112619502274000_15.11.e106366.7","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s00586-016-4892-7","article-title":"Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial","volume":"26","author":"Yilmaz Yelvar","year":"2017","journal-title":"Eur Spine J"},{"key":"2025112619502274000_15.11.e106366.8","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9082567","article-title":"Virtual Reality, Augmented Reality, Gamification, and Telerehabilitation: Psychological Impact on Orthopedic Patients\u2019 Rehabilitation","volume":"9","author":"Berton","year":"2020","journal-title":"J Clin Med"},{"key":"2025112619502274000_15.11.e106366.9","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jpain.2021.08.001","article-title":"The Use of Virtual Reality in Back Pain Rehabilitation: A Systematic Review and Meta-Analysis","volume":"23","author":"Bordeleau","year":"2022","journal-title":"J Pain"},{"key":"2025112619502274000_15.11.e106366.10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12984-020-00688-0","article-title":"Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial","volume":"17","author":"Matheve","year":"2020","journal-title":"J NeuroEngineering Rehabil"},{"key":"2025112619502274000_15.11.e106366.11","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s12178-022-09797-w","article-title":"Gamification in Musculoskeletal Rehabilitation","volume":"15","author":"Alfieri","year":"2022","journal-title":"Curr Rev Musculoskelet Med"},{"key":"2025112619502274000_15.11.e106366.12","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/sms.12899","article-title":"Effect of exergames on musculoskeletal pain: A systematic review and meta-analysis","volume":"28","author":"Collado-Mateo","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"2025112619502274000_15.11.e106366.13","unstructured":"Slatman S , Harvie D , van der Heijden M , et al . Reporting Guideline for Therapeutic Immersive Virtual Reality Interventions: International eDelphi Study (INVIRTUE);"},{"key":"2025112619502274000_15.11.e106366.14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2307\/41410412","article-title":"Consumer Acceptance and Use of Information Technology: Extending the Unified Theory of Acceptance and Use of Technology","volume":"36","author":"Venkatesh","year":"2012","journal-title":"MIS Q"},{"key":"2025112619502274000_15.11.e106366.15","unstructured":"Fraudet B , Le Blong E , Piette P , et al . Acceptation d\u2019une solution de r\u00e9alit\u00e9 virtuelle pour le sport: quels sont les facteurs pr\u00e9dictifs pour les personnes en situation de handicap. HAL 2021."},{"key":"2025112619502274000_15.11.e106366.16","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9119452"},{"key":"2025112619502274000_15.11.e106366.17","doi-asserted-by":"crossref","first-page":"9345","DOI":"10.3390\/su12229345","article-title":"Acceptance and Influencing Factors of Social Virtual Reality in the Urban Elderly","volume":"12","author":"Shao","year":"2020","journal-title":"Sustainability"},{"key":"2025112619502274000_15.11.e106366.18","doi-asserted-by":"crossref","first-page":"103127","DOI":"10.1016\/j.jretconser.2022.103127","article-title":"Integrated concepts of the UTAUT and TPB in virtual reality behavioral intention","volume":"70","author":"Huang","year":"2023","journal-title":"Journal of Retailing and Consumer Services"},{"key":"2025112619502274000_15.11.e106366.19","unstructured":"M\u00fctterlein J , Hess T . Immersion, presence, interactivity: towards a joint understanding of factors influencing virtual reality acceptance and use. 2017."},{"key":"2025112619502274000_15.11.e106366.20","doi-asserted-by":"crossref","unstructured":"Walsh KR , Pawlowski SD . Virtual Reality: A Technology in Need of IS Research. CAIS 2002;8. doi:10.17705\/1CAIS.00820","DOI":"10.17705\/1CAIS.00820"},{"key":"2025112619502274000_15.11.e106366.21","unstructured":"Brooke J . SUS - a quick and dirty usability scale."},{"key":"2025112619502274000_15.11.e106366.22","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1080\/10447318.2021.1898828","article-title":"Psychometric Evaluation of the F-SUS: Creation and Validation of the French Version of the System Usability Scale","volume":"37","author":"Gronier","year":"2021","journal-title":"International Journal of Human\u2013Computer Interaction"},{"key":"2025112619502274000_15.11.e106366.23","doi-asserted-by":"publisher","DOI":"10.1080\/10447310802205776"},{"key":"2025112619502274000_15.11.e106366.24","doi-asserted-by":"publisher","DOI":"10.1037\/h0087152"},{"key":"2025112619502274000_15.11.e106366.25","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00279-N"},{"key":"2025112619502274000_15.11.e106366.26","first-page":"126","article-title":"Validation of the French version of the Dallas Pain Questionnaire in chronic low back pain patients","volume":"65","author":"Marty","year":"1998","journal-title":"Rev Rhum Engl Ed"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-106366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T03:50:38Z","timestamp":1764215438000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-106366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":26,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,26]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bmjopen-2025-106366"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-106366","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}