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Chronic Low-back PainNCT06506604

"Psychological Intervention Enhanced by Virtual Reality for the Improvement of Appreciation of Body Functionality in Patients With Chronic Low-back-pain".

A study testing CLEVER in people with Chronic Low-back Pain, run by University of Valencia at 1 site in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to test whether a positive body image-based intervention is able to improve pain, disability, interference and emotional distress in people with chronic low back pain. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Chronic Low-back Pain
What is being tested?
CLEVER
Could I receive a placebo?
No, everyone receives an active treatment
How many people
13 participants
Where
1 siteSpain
Study dates
3 Jun 2024to 15 Jul 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Individuals with low back pain.

Who cannot join

  • Meeting any of the following medical conditions:
  • Spinal tumor, infection or fracture
  • Systemic disease (autoimmune, infectious, vascular, endocrine, metabolic...)
  • Fibromyalgia
  • Cauda equina syndrome
  • History of spinal surgery
  • Musculoskeletal injury of lower extremities

Trial locations and contacts

1 site in 1 country.

Spain1 site
  • Arnau de Vilanova Hospital

    Valencia, Valencia, 46015

Other trials in Spain

About this study

The purpose of this study is to test whether a positive body image-based intervention is able to improve pain, disability, interference and emotional distress in people with chronic low back pain.

Patients will receive 4 sessions approaching 5 different clinical modules: Pain Psychoeducation, Body Awareness, Pain Acceptance, Body Appreciation and Functionality and Gratitude. 2 sessions will include virtual reality (VR) environments to enhance the clinical outcomes.

Researchers will analyse changes in the variables of interest after intervention compared to baseline.

Read the detailed description

The purpose of this intervention is to examine the effects of a positive body image-based intervention using virtual reality to improve pain, interference and emotional distress.

The first session will be dedicated to psychoeducation about pain. Investigators will discuss what chronic pain is, what factors influence pain, chronification, body image and a brief presentation of the modules.

In the second session, a brief introduction to body awareness will be given and a VR environment will be used to carry out a body scan.

In the third session, Acceptance of pain will be worked on and a VR environment will be used to work on some variables related to the chronification of pain, such as paradoxical control or avoidance.

In the fourth session, the modules of Appreciation and Gratitude will be addressed.

Each session will last approximately one hour. First, participants will be screened to check eligibility inclusion/exclusion criteria. Second, eligible participants will complete baseline measures.

The study will be conducted following the principles stated in the Declaration of Helsinki.

The design chosen for the intervention will be a Multiple Baseline Single Case Design (SCD-MB). Data will be analysed by visual and statistical analysis. For visual analysis, the mean and/or median will be used to report the level, trend and stability of the 'within phase' data. For "between-phase" data, "Nonoverlap Statistics" such as "Nonoverlap of All Pairs" (NAP) will be used. For statistical analyses a Cohen's Difference of Means (Cohen's d) will be used to estimate the effect size at the individual level and multilevel analyses for across-case effect sizes.

Being tested
CLEVER

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CLEVERBehavioural

    CLEVER: A positive body image-based intervention for Chronic Low Back Pain.

    Patients will receive 4 sessions to approach 5 clinical modules: Pain Psychoeducation, Body Awareness, Pain Acceptance, Body Appreciation and Functionality and Gratitude. virtual reality environments will be used to enhance the clinical outcomes in two sessions. Each session will last 60 minutes.

Study groups in NCT06506604
Study groupRoleWhat they receive
Participants with low back pain. Multiple Base Line Single Case Design - 7 days waitExperimentalPositive body image-based intervention. Main Components: Psychoeducation, Body Awareness, Acceptance, Functionality Appreciation and Gratitude toward the body.
Receives: Behavioral: CLEVER
Participants with low back pain. Multiple Base Line Single Case Design - 10 days waitExperimentalPositive body image-based intervention. Main Components: Psychoeducation, Body Awareness, Acceptance, Functionality Appreciation and Gratitude toward the body.
Receives: Behavioral: CLEVER
Participants with low back pain. Multiple Base Line Single Case Design - 14 days waitExperimentalPositive body image-based intervention. Main Components: Psychoeducation, Body Awareness, Acceptance, Functionality Appreciation and Gratitude toward the body.
Receives: Behavioral: CLEVER
Participants with low back pain. Multiple Base Line Single Case Design - 11 days waitExperimentalPositive body image-based intervention. Main Components: Psychoeducation, Body Awareness, Acceptance, Functionality Appreciation and Gratitude toward the body.
Receives: Behavioral: CLEVER

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Body Disability

    Roland-Morris Questionnaire (RMQ) is a 24-item patient-reported outcome measure those inquiries about pain-related disability. Items are scored 0 if left blank or 1 if endorsed, for a total RMQ score ranging from 0 to 24.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  2. Emotional Distress

    The 4-item Brief Assessment of Distress about Pain (BADP) scale was developed to assess anxiety, fear, and depression related to pain, as well as an overall evaluation of distress about pain. Items are scored from 0 ("Not at all") to 4 ("Extreme"), for a total BADP score ranging from 0 to 16.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  3. Pain Interference and Pain Intensity

    The Brief Pain Inventory (BPI) scale was developed to assess the severity of pain and its impact on functioning. The scale consists of 9 items with qualitative and quantitative data on the following dimensions: "Worst pain in last 24 hours", "Least pain in last 24 hours", "Pain on average" and "Pain right now".

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  4. Level of Quality of Life

    The EuroQol-5D (EQ-5D) scale is a 5-item scale to assess the quality of life of patients with several pathologies, chronic pain included. The individual assesses his or her own state of health, first in levels of severity by dimensions (descriptive system) and then on a more general visual analogue scale (VAS).

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

Secondary outcomes (9)
  1. Fear of movement

    The Tampa Scale for Kinesophobia (TSK-11SV) is an 11-item scale that measures kinesophobia with statements asking the subject to answer from 1 ("Strongly disagree"), to 4 ("Strongly agree").

    Two items: 'I'M AFRAID OF UNINTENTIONALLY INJURING MYSELF', ´PHYSICAL ACTIVITY AGGRAVATES MY PAIN´ will be administered daily for 43 days via MPATH

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  2. Body Awareness

    Dimensions of "Not Worrying" (items 9, 10 and 11), "Not distracting" (items 5, 6 and 7) and "Trusting" (items 30, 31 and 32) from the Multidimensional Assessment of Interoceptive Awareness (MAIA) will be used. This scale is a state-trait self-report questionnaire to measure multiple dimensions of interoception (awareness of bodily sensations). These dimensions have been chosen for their relationship to the intervention components and for their good psychometric quality. The scores range from 0 to 5, where higher scores indicate a higher level in that dimension.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43) and one of the items of the scale: 'I NOTICE WHEN I FEEL UNCOMFORTABLE IN MY BODY´ will be administered daily for 43 days via MPATH.

  3. Body Awareness

    The following items have been created ad-hoc for this experiment:

    1. In general, I am able to pay attention to both pleasant and unpleasant bodily sensations.
    2. When I feel pain, I am also able to notice pleasant bodily sensations.
    3. Today I have noticed pleasant bodily sensations.
    4. Today I have noticed unpleasant bodily sensations.
    5. I am able to notice and differentiate the various sensations I experience in my body, regardless of whether they are pleasant or unpleasant (examples).
    6. I have the ability to pay attention to body signals, whether positive or negative.
    7. I am aware of physical sensations in my body, whether pleasant or uncomfortable.

    One of the items of the scale: 'TODAY I HAVE NOTICED PLEASANT BODILY SENSATIONS´ and 'TODAY I HAVE NOTICED UNPLEASANT BODILY SENSATIONS´ will be administered daily for 43 days via MPATH.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  4. Chronic Pain Acceptance

    Chronic Pain Acceptance Questionnaire 8 (CPAQ-8). Numerical rating scale ranging from 0 "Never true" to 6 "Always true" where higher scores indicate a higher Chronic Pain Acceptance (Pain Willingness and Activity Engagement).

    Two items: 'WHETHER I FELT PAIN OR NOT, I HAD A SATISFACTORY DAY´ and 'WHETHER I FELT PAIN OR NOT, I HAVE HAD A SATISFYING DAY TODAY´ will be administered daily for 43 days via MPATH.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  5. Body Appreciation

    Body Appreciation Scale 2 (BAS-2). Numerical rating scale ranging from 1 "Never" to 5 "Always", 10 items where higher scores indicate a higher Appreciation of the body.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43) and one of the items of the scale -'I FEEL LOVE AND RESPECT FOR MY BODY'- will be administered daily for 43 days via MPATH.

  6. Appreciation of Body Functionality

    Functionality Appreciation Scale (FAS). The scores range from 1 to 5, where higher scores indicate higher levels of appreciation of body functionality.

    Two items of the scale -'I APPRECIATE MY BODY FOR WHAT IT IS ABLE TO DO'- and -'I AM GRATEFUL THAT MY BODY ALLOWS ME TO BE INVOLVED IN ACTIVITIES THAT I ENJOY OR THAT SEEM IMPORTANT TO ME´ will be administered daily for 43 days via MPATH

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  7. Pain Catastrophizing

    The Pain Catastrophizing Scale (PCS) consists of 13 statements containing a number of thoughts and feelings typically present in the experience of pain. The items are divided into 3 categories: rumination, magnification and helplessness, with each item scored on a 5-point scale. The patient is asked to indicate the frequency with which these feelings or thoughts appear from 0 ("Not at all") to 4 ("All the time").

    Two of the items of the scale: -'I'M AFRAID THE PAIN WILL GET WORSE'- and -'I CAN'T STOP THINKING ABOUT HOW MUCH IT HURTS'- will be administered daily for 43 days via MPATH

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  8. Depression

    The Patient Health Questionnaire (PHQ-9). The scale is composed of 9 items to assess depressive symptoms and the patient is asked to indicate the frequency with which these feelings, thoughts or states appear from 0 ("Not at all) to 3 ("Nearly every day").

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

  9. Anxiety

    The Generalised Anxiety Disorder-7 (GAD-7) scale is composed of 7 items to assess the different dimensions of the Generalised Anxiety Disorder and the patient is asked to mark the frequency from 'Never' to 'almost every day' in the last two weeks.

    Measured: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jul 2024
  2. Study start3 Jun 2024
  3. Primary completion3 Jun 2024
  4. Study completion15 Jul 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multiple Baseline Single Case Design
Masking
Single blind
Who is masked
Participant
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06506604
Sponsor's protocol ID
PID2020-115609RB-C21
Status last verified
Jan 2025
First submitted
27 Jun 2024
Last updated
22 Jan 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Valenzuela-Moguillansky C, Reyes-Reyes A, Gaete MI. Exteroceptive and Interoceptive Body-Self Awareness in Fibromyalgia Patients. Front Hum Neurosci. 2017 Mar 13;11:117. doi: 10.3389/fnhum.2017.00117. eCollection 2017.

    PubMed 28348526
  • Bailey KA, Gammage KL, van Ingen C, Ditor DS. "It's all about acceptance": A qualitative study exploring a model of positive body image for people with spinal cord injury. Body Image. 2015 Sep;15:24-34. doi: 10.1016/j.bodyim.2015.04.010. Epub 2015 May 21.

    PubMed 26002149
  • Alleva JM, Diedrichs PC, Halliwell E, Peters ML, Dures E, Stuijfzand BG, Rumsey N. More than my RA: A randomized trial investigating body image improvement among women with rheumatoid arthritis using a functionality-focused intervention program. J Consult Clin Psychol. 2018 Aug;86(8):666-676. doi: 10.1037/ccp0000317.

    PubMed 30035583
  • Kratochwill TR, Levin JR. Enhancing the scientific credibility of single-case intervention research: randomization to the rescue. Psychol Methods. 2010 Jun;15(2):124-44. doi: 10.1037/a0017736.

    PubMed 20515235

Questions about this trial

What is this clinical trial studying?

A study testing CLEVER in people with Chronic Low-back Pain, run by University of Valencia at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Body Disability (time frame: The whole scale will be administered at the beginning (day 1 of 43) and the end of the intervention (day 43 of 43).). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06506604, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2025.

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