BACKGROUND: Lumbar disc herniation is a prevalent condition that leads to pain, disability, and a reduction in quality of life. While conventional treatments are widely utilized, virtual reality-based exercise programs present a promising alternative. However, the effectiveness of these exercises in the rehabilitation of lumbar disc herniation remains unclear. The aim of this study was to evaluate the effects of virtual reality-based exercises on pain, daily activities, quality of life, and fall risk in individuals with lumbar disc herniation. MATERIALS AND METHODS: This randomized controlled trial included 68 patients meeting the study criteria. INCLUSION CRITERIA: No other physical disabilities, no surgery in the last 6 months, no uncontrolled diseases, no vertigo, knee or joint issues, moderate/low balance impairment, and body mass index below 40. EXCLUSION CRITERIA: Uncontrolled diseases, vertigo, knee/joint issues, cognitive impairments, pregnancy, inability to complete fall risk measurement, or attend follow-ups. Participants were divided into a virtual reality group (n = 34, Mean age +/- Standard Deviation 51.05 +/- 13.39, 41.2% male, 58.8% female) and a control group (n = 34, Mean age +/- Standard Deviation 53.55 +/- 12.25, 29.4% male, 70.6% female). The virtual reality group performed 28 sessions of virtual reality -based exercises, while the control group received routine hospital treatment. The study was conducted in a single hospital due to equipment limitations in the region. Data were collected using the Patient Information Form, Visual Analog Scale, Oswestry Disability Index, Short Form-36 Quality of Life Scale, and Fall Risk Device. Statistical analyses were performed using Statistical Package for the Social Sciences 20, including t-tests, chi-square tests, effect size analysis, and skewness/kurtosis assessments for homogeneity. RESULTS: The virtual reality group showed a significant reduction in pain (Visual Analog Scale 3.38 +/- 1.48, Cl -2.49 to -0.86, p < 0.05) and disability (Oswestry Disability Index 21.59 +/- 6.00, Cl -19.92 to -7.38, p < 0.05), along with significant improvements in all Short Form-36 Quality Of Life sub-dimensions (p < 0.05). Fall risk scores also decreased significantly in the virtual reality group (Cl -26.57 to -7.26, p < 0.05). There were no significant baseline differences between the groups, confirming their comparability before the intervention. CONCLUSION: Virtual reality -based exercises effectively reduced pain, improved daily activities and quality of life, and decreased fall risk in lumbar disc herniation patients, suggesting their potential as a complementary rehabilitation approach. Blinding was not applied due to the nature of the interventions, which may introduce a potential risk of bias. TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (Clinical trial number: NCT05463588; Registration date: 08/07/2022). The study was retrospectively registered.

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