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Background: Psychoeducation positively influences the psychological components of chronic low back pain (CLBP) in conventional treatments. The digitalization of health care has led to the discussion of virtual reality (VR) interventions. However, CLBP treatments in VR have some limitations due to full immersion. In comparison, augmented reality (AR) supplements the real world with virtual elements involving one’s own body sensory perception and can combine conventional and VR approaches.
Objective: The aim of this study was to review the state of research on the treatment of CLBP through psychoeducation, including immersive technologies, and to formulate suggestions for psychoeducation in AR for CLBP.
Methods: A scoping review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in August 2024 by using Livivo ZB MED, PubMed, Web of Science, American Psychological Association PsycINFO (PsycArticle), and PsyArXiv Preprints databases. A qualitative content analysis of the included studies was conducted based on 4 deductively extracted categories.
Results: We included 12 studies published between 2019 and 2024 referring to conventional and VR-based psychoeducation for CLBP treatment, but no study referred to AR. In these studies, educational programs were combined with physiotherapy, encompassing content on pain biology, psychological education, coping strategies, and relaxation techniques. The key outcomes were pain intensity, kinesiophobia, pain catastrophizing, degree of disability, quality of life, well-being, self-efficacy, depression, attrition rate, and user experience. Passive, active, and gamified strategies were used to promote intrinsic motivation from a psychological point of view. Regarding user experience from a software development perspective, user friendliness, operational support, and application challenges were recommended.
Conclusions: For the development of a framework for an AR-based psychoeducational intervention for CLBP, the combination of theories of acceptance and use of technologies with insights from health psychological behavior change theories appears to be of great importance. An example of a theory-based design of a psychoeducation intervention in AR for CLBP is proposed and discussed.
Background: Chronic low back pain (CLBP) is prevalent and a multimodal therapy is indicated, including psychological treatment. Effective conventional treatments involve psychoeducation and mindfulness-based body scans, while virtual reality offers superior but temporary pain relief. Augmented Reality (AR), which combines conventional and virtual methods, is a novel therapeutic strategy.
Methods: We investigated the viability and acceptability of an AR intervention for CLBP by incorporating psychoeducation and mindfulness-based body scan techniques. 40 participants in two studies with a one-arm design underwent an educational AR intervention (Study I, n1 = 18) and an enhanced version with an additional body scan (Study II, n2 = 22). The studies focused on evaluating technical feasibility and multiple facets of user experience.
Results: The results demonstrated high feasibility with low dropout rates (Study I: 10%, Study II: 0%). User experience ratings ranged from “Above Average” to “Excellent,” with the advanced intervention receiving higher ratings. While Study I showed no significant changes in affect pre- vs. post-intervention, Study II exhibited a significant reduction in negative affect and improved valence. Qualitative analysis provided insights into technical requirements and user perceptions.
Discussion: The AR prototype emerges as a promising psychoeducational tool for CLBP, aligning with current treatment guidelines and providing a basis for future controlled clinical trials. Limitations include the absence of a high-pain intervention group, as Study I reported a pain intensity of M = 1.05 and Study II reported M = 1.77 (Range: 0–10). Further research such as clinical trials with control groups is required to validate the efficacy of the piloted approach. The AR-based psychoeducation and mindfulness body scan intervention for CLBP demonstrated technical feasibility and a good user experience.
