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RecruitingNCT05005026VRWalkUpdated Dec 17, 2025

Virtual Walking Intervention for Neuropathic Pain in Spinal Cord Injury

An interventional study of VR Game 1 and VR Game 2 in Spinal Cord Injuries and Neuropathic Pain, sponsored by Texas A&M University. Recruiting at 3 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-17.

Sponsored by Texas A&M University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Nov 2021; still recruiting 4 years 10 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to determine if playing a virtual reality walking game can help improve neuropathic pain in adults with chronic spinal cord injury.

Read the detailed description

Many people with SCI experience neuropathic pain. Neuropathic pain is often described as sharp, burning, or electric. 'Traditional' treatments often do not do a good job of reducing neuropathic pain. Therefore, it is important to see if 'non-traditional' treatments might work. Scientists think that neuropathic pain occurs in SCI because the sensations coming from the eyes and up the spinal cord to the brain do not match what the brain thinks it told the body to do. This 'mis-match' may result in changes in the brain that make neuropathic pain possible. Virtual reality walking reduces this 'mis-match.' It does this by creating the 'illusion' that the person is walking. The brain then thinks it is telling the body to walk AND the information coming from the eyes matches its instructions. This 'matching' may reverse the brain changes that made neuropathic pain possible. The current study is specifically focused on individuals whose SCI has been classified as complete (ASIA A).

02

Conditions studied

  • Spinal Cord Injuries
  • Neuropathic Pain
03

In context

Spinal Cord Injuries

1,948 studies on the registry are indexed under Spinal Cord Injuries; 505 are open to participants now.

This study's planned enrollment of 250 is above the median of 24 across 1,566 interventional studies indexed under Spinal Cord Injuries.

Browse Spinal Cord Injuries studies →

Lead sponsor

Texas A&M University is the lead sponsor of 123 studies on the registry; 23 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 2 (29%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

The study will recruit individuals with complete injury (American Spinal Injury Association [ASIA] classification A) with lumbar, paraplegic, or low tetraplegic (C5-C7) injury. Additional criteria will include:

  1. Must have persistent NP symptoms that are of daily severity of at least 4/10 for 3 or more months
  2. Must endorse more than 2 items on a 7-item Spinal Cord Injury Pain Instrument, SCIPI
  3. Must be 18 years of age or older
  4. Must be more than one year post-injury to begin study (can be screened at an earlier time for eligibility)
  5. Must have mobile connectivity with usable service
  6. Must be stable on pain medication for 1 or more months
  7. Must be cleared on the VRWalk physical activity clearance scale
  8. Must not have motion sickness that interferes with daily life

Exclusion criteria

Exclusion Criteria:

  1. Individuals with Injury levels between C1 and C4
  2. Individuals under the age of 18
  3. Individuals who were injured within the past year
  4. Individuals who cannot comprehend spoken English
  5. Individuals who are in prison
  6. Individuals who are blind
  7. Individuals who experience severe motion sickness
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
250 participants (estimated)

Study arms

  • Active comparator
    Virtual reality (VR) game 1

    Participants will be asked to play a virtual reality game twice a day for 10 days.

    Other: VR Game 1

  • Active comparator
    Virtual reality (VR) game 2

    Participants will be asked to play a virtual reality game twice a day for 10 days.

    Other: VR Game 2

Interventions

  • OtherVR Game 1

    Individuals playing VR game 1 will wear a head-mounted display to allow them to visualize virtual legs in the virtual environment. When wearing the display, individuals will see the legs and arms of their virtual avatar from a first-person perspective. Individuals will engage in virtual reality sessions in their home twice daily over the course of 10 days in a two-week period. Each daily session will take approximately 30 minutes, with 5-10 minutes dedicated to the virtual walking experience. Additionally, each daily session will be scheduled a minimum of 4 hours apart.

  • OtherVR Game 2

    Individuals playing VR game 2 will wear a head-mounted display to allow them to visualize virtual legs in the virtual environment. When wearing the display, individuals will see the legs and arms of their virtual avatar from a first-person perspective. Individuals will engage in virtual reality sessions in their home twice daily over the course of 10 days in a two-week period. Each daily session will take approximately 30 minutes, with 5-10 minutes dedicated to the virtual walking experience. Additionally, each daily session will be scheduled a minimum of 4 hours apart.

06

What researchers measure

Primary outcomes

  1. Change in Pain Intensity

    The Numeric Rating Scale (NRS) measures pain intensity via 0-10 numeric rating scale 0-10 where 0 is no pain and 10 is the worst pain imaginable.

    Time frame: Baseline - final follow up (up to 18 months)

Secondary outcomes

  1. Change in Pain Quality

    The Neuropathic Pain Scale (NPS) assesses the distinct pain qualities including sharpness, heat/cold, dullness, intensity, overall unpleasantness, and surface vs. deep pain. The NPS consists of 10 items. All the items are rated 0-10 scale, with higher score indicative of more neuropathic pain for each type of respective pain.

    Time frame: Baseline - final follow up (up to 18 months)

  2. Change in Pain Interference

    The International Spinal Cord Injury Pain Basic Data Set version 2.0 interference assesses the degree to which pain interferes with day-to-day activities, mood, and sleep. Items are scored on a 0-10 numeric rating scale and scores are summed to yield an interference score ranging from 0 to 30. Higher scores indicate greater interference from pain.

    Time frame: Baseline - final follow up (up to 18 months)

  3. Post treatment change

    The Patient Global Impression of Change is a one item 7 point Likert item assessing improvement of the participants overall status. A score of 1 is 'Very Much Improved', and a score of 7 is 'Very Much Worse.' Higher scores indicate less perceived improvement. Range of scores: 1-7

    Time frame: at follow up (up to 18 months)

  4. Change in mood

    Mood will be assessed using the Patient Health Questionnaire-9. Participants will be asked to rate how often they have been bothered by specific problems on a 4-point Likert scale, where 0 is 'Not at all,' and 3 is 'Nearly every day.' The items are summed to yield a score ranging from 0-27. Higher scores indicate worse mood.

    Time frame: Baseline - final follow up (up to 18 months)

  5. Change in quality of life

    Quality of life is assessed by the Satisfaction with Life Scale. This is a 5 item survey. Response options are a 7-point Likert scale where 1 is 'Strongly disagree,' and 7 is 'Strongly agree'. Items may be assessed individually or by summing items. Range of scores: 5-35. Higher scores indicate more satisfaction in life

    Time frame: Baseline - final follow up (up to 18 months)

  6. Neurological changes

    For eligible and interested participants, functional Magnetic Resonance Imaging (fMRI) will be used to observe neurological changes. Pre and post-study images will be compared by experienced researchers.

    Time frame: Baseline - 6 months

07

Study locations

2 of 3 sites recruiting
  • University of Alabama at Birmingham
    Birmingham, Alabama 35294, United States
    • Rachel Cowan, PhD · Contact · recowan@uabmc.edu
    • Rachel Cowan, PhD · Principal investigator
    Recruiting
  • Texas A&M University
    College Station, Texas 77843, United States
    • Amanda D Sainz-Higgins · Contact
    • · Contact · sci@vrwalk.org
    • Zina Trost, PhD · Principal investigator
    Recruiting
  • University of New South Wales
    Sydney, New South Wales, Australia
    Completed
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 17, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05005026
Lead sponsor
Texas A&M University
Collaborators
United States Department of Defense, Richmond VA Medical Center, Immersive Experience Labs
Responsible party
Sponsor
First posted
Aug 13, 2021
Start date
Nov 23, 2021
Primary completion
Sep 2026 (estimated)
Completion
Sep 2026 (estimated)
Last update
Dec 17, 2025

Study contacts

Amanda Sainz-Higgins, M.E.d
Contact
sci@vrwalk.org
804-569-5965
Zina Trost, PhD
principal investigator · Texas A&M University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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