The Effect of Core Stabilization Exercises Applied With Virtual Reality-Based Telerehabilitation in the Treatment of Chronic Low Back Pain

It is a commonly used and validated scale for measuring disability in low back pain. It consists of a total of 10 questions. Each question is scored on a scale of 0 to 5. Higher scores indicate worse symptoms or functioning.

The severity of pain before treatment is assessed using the Visual Analog Scale (VAS), a 10 cm long line with "no pain" on the left end and "unbearable pain" on the right end. The distance in centimeters between the point marked by the patient and the 0 point is measured. The average pain level before and after treatment will be evaluated using the VAS, scored between 0 and 10; 0 indicates no pain, and 10 indicates the worst possible pain.

It is a validated scale used to measure disability in low back pain. The total score ranges from 0 (no disability) to 24 (severe disability). A higher total score indicates decreased patient functionality. Higher scores reflect worse symptoms or function.

The Tampa Scale for Kinesiophobia is a 17-item tool used to assess fear of movement. A 4-point Likert scoring system is used in the questionnaire. Items 4, 8, 12, and 16 are reverse scored, and the total score is calculated by summing all items. The total score ranges from 17 to 68. A higher score on the scale indicates a higher level of kinesiophobia.

Ultrasonographic evaluation will be performed using the Esaote Mylab 60 device. The resting muscle thickness of the lumbar multifidus will be measured longitudinally with a convex probe at the L4-L5 facet level at the end of expiration while the patient is in the prone position. After the contralateral arm-raising maneuver, the contracted thickness of the multifidus will be measured at the same level.

The transversus abdominis measurement will be performed at the end of expiration in the supine position, with knees bent, heels resting on the table, and hands placed under the head. A linear probe will be used at the midpoint between the 12th rib and the iliac crest, 2.5 cm anterior to the mid-axillary line. Following the ipsilateral straight leg raise maneuver, the contracted transversus abdominis thickness will be measured at the same level.

In our study, trunk extensor and flexor muscle strengths will be measured with a Biodex System 3-Pro (Biodex Medical Systems, Inc, New York, USA) computerized isokinetic dynamometer machine. Maximum strength will be used to perform trunk extension and flexion at speeds of 60°/s, 90°/s, and 120°/s, respectively, with 5 repetitions at each speed. Peak torque and total work values of the participants will be recorded.