Evidence map›Paper›PMID 41699236›Full record

ArticleNPJ digital medicine2026

Randomized-controlled trial of skills-based vr vs. distraction vr vs. sham VR for chronic low back pain.

Brennan M R Spiegel, Samuel A Eberlein, Susan Persky, Mariko L Ishimori, Swamy Venuturupalli, Joseph Tu, Fadi Alhatem, Mary A Vijjeswarapu, Zoe Krut, Tom Norris and 8 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04409353 (Randomized-controlled Trial of Virtual Reality for Chronic Low Back Pain to Improve Patient-reported Outcomes and Physical Activity), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04409353 nacompletednot on this map

Randomized-controlled Trial of Virtual Reality for Chronic Low Back Pain to Improve Patient-reported Outcomes and Physical Activity

TypeinterventionalSponsorCedars-Sinai Medical CenterRan2020 to 2024Enrolled413ConditionsChronic Low Back PainArmsDistraction-Based VR, Sham VR, Skills-Based VR, Activity Tracker
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Brennan M R SpiegelCedars-Sinai Medical Center, Center for Virtual Medicine and Health System Transformation, Los Angeles, CA, USA. brennan.spiegel@cshs.org.
Samuel A EberleinCedars-Sinai Medical Center, Center for Virtual Medicine and Health System Transformation, Los Angeles, CA, USA.
Susan PerskySocial and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, USA.
Mariko L IshimoriCedars-Sinai Medical Center, Department of Medicine, Division of Rheumatology, Los Angeles, CA, USA.
Swamy VenuturupalliCedars-Sinai Medical Center, Department of Medicine, Division of Rheumatology, Los Angeles, CA, USA.
Joseph TuCedars-Sinai Medical Center, Department of Physical Medicine and Rehabilitation, Los Angeles, CA, USA.
Fadi AlhatemCedars-Sinai Medical Center, Department of Physical Medicine and Rehabilitation, Los Angeles, CA, USA.
Mary A VijjeswarapuCedars-Sinai Medical Center, Department of Physical Medicine and Rehabilitation, Los Angeles, CA, USA.
Zoe KrutCedars-Sinai Medical Center, Center for Virtual Medicine and Health System Transformation, Los Angeles, CA, USA.
Tom NorrisAmerican Chronic Pain Association, Overland Park, KS, USA.
So Yung ChoiCedars-Sinai Medical Center, Biostatistics Shared Resource, Department of Computational Biomedicine, Los Angeles, CA, USA.
Mourad TighiouartCedars-Sinai Medical Center, Biostatistics Shared Resource, Department of Computational Biomedicine, Los Angeles, CA, USA.
Lindsey RossCedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA.
Mark VrahasCedars-Sinai Medical Center, Department of Orthopaedic Surgery, Los Angeles, CA, USA.
Omer LiranCedars-Sinai Medical Center, Center for Virtual Medicine and Health System Transformation, Los Angeles, CA, USA.
Itai DanovitchCedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neuroscience, Los Angeles, CA, USA.
Tinh VuongThe Saban Clinic, Los Angeles, CA, USA.
Joshua FouladianCedars-Sinai Medical Center, Center for Virtual Medicine and Health System Transformation, Los Angeles, CA, USA.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Randomized-controlled trial of virtual reality for chronic low back pain to improve patient-reported outcomes and physical activity: Understanding Patient Predictors of ResponseUH3AR076573 · NIAMS · CEDARS-SINAI MEDICAL CENTER · PI SPIEGEL, BRENNAN · 2020 to 2023
$4.4M
NCATS NIH HHS UL1TR001881NIAMS NIH HHS UH3AR076573
6 · The paper itself

Abstract

Chronic low back pain (cLBP) significantly impacts quality of life, highlighting the need for safe, home-based, non-pharmacological therapies. This study (NCT04409353) evaluated three interventions utilizing Virtual Reality (VR) for managing cLBP. 385 participants were randomized across three groups: Skills-Based VR (biofeedback, interoceptive training, and relaxation), Distraction VR (immersive 360-degree videos), and Sham VR (2D videos). The primary outcome was the change in PROMIS Pain Interference (PI). Secondary outcomes included the change in physical function, anxiety, depression, sleep disturbance, opioid use, and Fitbit-measured steps and sleep efficiency. No significant differences were observed between active VR (Skills-Based and Distraction) and Sham VR for the primary or most secondary outcomes. Secondary findings indicated a greater reduction in daily opioid use in the Distraction VR group compared to Sham VR (p = 0.009), and exploratory analyses revealed that baseline anxiety significantly predicted PROMIS-PI improvement within the Skills-Based VR (p = 0.025) group. Depression symptoms showed no such association. Adverse events were predominantly mild and self-limited, with cybersickness being the most common. Neither active VR program outperformed Sham VR for the primary outcome. High adherence across groups underscored the feasibility of home-based VR. Future studies, powered to test anxiety-moderated treatment effects and opioid-use reduction as primary outcomes, are warranted.

Identifiers

PMID41699236
PMCPMC13022439

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.