Contrasting the Effects of Exergaming using Virtual Reality vs. Neck Resistance Training on Pain, Mobility, and Kinesiophobia in Acute Cervical Pain among Collegiates – A preliminary study

Published: 21 May 2024| Version 1 | DOI: 10.17632/55wkvg2w4s.1
Rachita Majhi, Gurjant Singh


Background: Cervical pain (CP) has garnered significant attention in the last two decades due to its widespread impact, affecting approximately half of the population and coming in at number four among the primary causes of impairment. CP's effects extend to daily activities and employment, notably in technologically advanced environments like schools and workplaces. Understanding CP's nature and classification is crucial for effective management and prevention strategies. Aim & Objectives: To compare the effects of exergaming using Virtual reality (VR) with neck resistance training (NRT) on pain, mobility, and kinesiophobia in collegiate individuals with acute cervical pain Materials and methods: Twenty-six collegiate individuals with acute CP participated in a randomized controlled trial. One group received NRT, while the other engaged in VR exergaming. Pain, mobility, and kinesiophobia were evaluated using the Tampa Scale, range of motion (ROM) measurements, and the Numeric Pain Rating Scale (NPRS) over a three-week period both before to and following the intervention. Results and Discussion: Significant pain relief (Median = 1.50, p = 0.139) was seen by both groups following the intervention, although starting at identical pain levels (Median = 4.00). Cervical mobility, especially in rotations, significantly improved (p < 0.05). The post-intervention level of kinesiophobia considerably decreased (Median = 20.00, p = 0.022). Pain (z = -3.250, p = 0.001; Group 2: -3.228, p = 0.01), kinesiophobia (z = -3.062, p = 0.002; Group 2: z = -3.072, p = 0.002), and cervical mobility (p < 0.01 for Group 1; p < 0.05 for Group 2) were all significantly reduced within each group. Both genders showed significant improvement in post-intervention kinesiophobia and pain levels. Conclusion: The study saw notable pain reduction and decreased kinesiophobia after VR and NRT. Neck mobility measures remained relatively stable pre- and post-intervention in both groups. This shift from moderate to mild pain and lower kinesiophobia levels suggests combining these methods could improve acute CP management. Keywords: Acute cervical pain, Exergaming, Neck pain, Neck resistance training, Virtual reality, Virtual reality training.


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Firstly, all 26 participants signed an informed consent form prior to participation. The inclusion and exclusion criteria were used as the foundation for recruiting participants. Following recruitment, a preliminary analysis was conducted with demographic information, including age, height, weight, and BMI (Body Mass Index) of each subject noted. The study's outcome measurements were listed as follows: • NPRS • Cervical Range of Motion (ROM) • Tampa Scale After eligibility screening using a purposive sampling method, participants were randomly allocated to either VR Exergaming or Neck Resistance Training groups using a well-established randomization technique (computer-generated sequence). During the course of three weeks, the intervention was carried out three times per week. In Group 1, participants received a 10-minute hot pack application to the neck or pain site, followed by a 20-minute exergaming session with VR.VRT was administered using the JioDive 360-degree VR headset equipped resin lenses. This VR device is agreeable with Android and iOS smartphones ranging from 4.7 inches to 6.7 inches in screen size. Participants were seated on a chair during the sessions, and instructions were given to minimize thoracic movements through verbal cues provided by the therapist. The mobile device utilized for VRT was the One plus 8, featuring a 6.6-inch display with a screen resolution of 1080*2400 pixels. The VRT utilized the "Froggy VR" game, available for free on the Google Play Store under the games section. Group 2 underwent a similar 10-minute hot pack application, followed by a 20-minute NRT session using a theraband. Weekly progression in theraband resistance was implemented, ranging from extra light to light and medium theraband. Finally, participants filled out the questionnaires again after the intervention period.


Chandigarh University


Physical Therapy, Exercise Rehabilitation, Exercise Therapy