Effects of device-based and manual sensory acuity training on nonspecific chronic low back pain: a three-arm randomized controlled trial protocol

BACKGROUND: Nonspecific chronic low back pain (NCLBP) is a prevalent and disabling condition often associated with impaired sensory discrimination and altered cortical representation. Sensory acuity training (SAT) has emerged as a promising strategy to target these neurophysiological mechanisms; however, the comparative effectiveness of technology-based versus manual sensory acuity interventions remains unclear. This protocol comprises a three-arm, randomized controlled trial designed to evaluate the effects of technology-based and manual SAT, in addition to conventional physiotherapy, compared with conventional physiotherapy alone, on pain and sensory discrimination performance in individuals with NCLBP. METHODS: This single-blind, three-arm parallel randomized controlled trial will recruit 66 adults with NCLBP (> 3 months). Participants will be randomly allocated (1:1:1) to the technology-based SAT, the manual SAT, or a control group. All participants will also receive 30 min of conventional physiotherapy, three times per week for 4 weeks. A blinded assessor will conduct evaluations at baseline, post-intervention, and follow-up. Primary outcomes include pain intensity measured by the visual analog scale, disability evaluated using the Roland-Morris Disability Questionnaire, manual two-point discrimination testing, and sensory acuity performance assessed through TactiPain parameters. Secondary outcomes include pressure pain threshold, joint position sense, laterality performance, central sensitization levels, fear of movement, pain catastrophizing, lumbar body awareness, and quality of life. DISCUSSION: This trial aims to provide high-quality evidence on whether technology-based SAT offers additional benefits compared with manual SAT or a control intervention. By addressing cortical- and sensory-based mechanisms underlying NCLBP, this study may inform the development of more targeted rehabilitation strategies, contribute to clinical decision-making, and guide future research on technology-assisted approaches in musculoskeletal pain rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov NCT07277803. Registered on December 2025.