All ETDs from UAB

Advisory Committee Chair

David Morris

Advisory Committee Members

David A Brown

Kristin R Archer

Alan Eberhardt

William Reed

Zina Trost

Document Type

Dissertation

Date of Award

2020

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Chronic low back pain (cLBP), low back pain persisting longer than three to six months, is a prevalent condition that can greatly interfere with movement quality. Specifically, cLBP can result in slower walking speeds and negatively affect reaching movements. Virtual reality (VR) encompasses a variety of technologies which may potentially improve therapeutic interventions for individuals with cLBP by presenting users with fun, distracting, and engaging challenges that align with their rehabilitative goals. While VR systems have become more accessible to everyday users, there is limited research which specifically examines VR mechanisms to improve walking and reaching quality. This dissertation presents three novel VR applications specifically developed for individuals with cLBP, each designed with a specific VR mechanism to improve movement. Study 1 examines the feasibility and content validity of a graded exposure walking and reaching application, which progressively introduces more difficult movement challenges over six modules. Studies 2 and 3 present the effects of a goal-oriented walking and reaching VR application that provides modulated visual feedback of walking speed (Study 2) and reaching distance (Study 3) during movement. Study 1 showed that despite experiencing pain and elevated pain-related fear, individuals with cLBP could successfully complete walking and reaching challenges in VR that progressively became more difficult. Study 2 showed that in both participants with and without cLBP, visual feedback that understated real-time walking speed in VR resulted in faster walking speeds compared to unmodulated visual flow in VR. Finally, Study 3 showed that while participants with and without cLBP could reach farther in VR compared to a no-VR reaching task, there were no positive benefits of modulating the visual feedback of reaching distance in VR. These three studies demonstrated the importance of selectively implementing VR mechanisms which target movement improvements and indicate that VR may be an effective tool to engage individuals with cLBP in fun physical challenges targeted to improve walking and reaching function.

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