Effect Of Pain Neuroscience Education Followed By Cognition-Targeted Motor Control Training On Pain, Disability, Central Sensitization And Kinesiophobia In Patient With Nonspecific Chronic Low Back Pain

Letafatkar, Amir; Amini, Faranak; Sheikhi, Bahram

doi:10.61186/jsmt.22.27.135

Volume 22, Issue 27 (8-2024) RSMT 2024, 22(27): 135-154 | Back to browse issues page

‎ 10.61186/jsmt.22.27.135

Mendeley

Zotero

RefWorks

Letafatkar A, Amini F, Sheikhi B. Effect Of Pain Neuroscience Education Followed By Cognition-Targeted Motor Control Training On Pain, Disability, Central Sensitization And Kinesiophobia In Patient With Nonspecific Chronic Low Back Pain. RSMT 2024; 22 (27) :135-154
URL: http://jsmt.khu.ac.ir/article-1-604-en.html

Effect Of Pain Neuroscience Education Followed By Cognition-Targeted Motor Control Training On Pain, Disability, Central Sensitization And Kinesiophobia In Patient With Nonspecific Chronic Low Back Pain

Amir Letafatkar

, Faranak Amini

, Bahram Sheikhi

Associate Professor, Faculty of physical education and sports sciences, Faculty of Physical Education, Kharazmi University, Tehran, Iran. , letafatkaramir@yahoo.com

Abstract: (2705 Views)

Introduction: The aim of this study was to compare the effectiveness of a combination of pain neuroscience education and targeted cognitive motor control training with targeted cognitive motor control training alone in patients with chronic low back pain.
Materials and Methods: Fifty-four chronic low back pain patients (pain neuroscience education with targeted cognitive motor control training group, n=27 and targeted cognitive motor control training only group, n=27) participated in this study. Pain, disability, central sensitization inventory, and kinesiophobia were assessed at baseline and eight weeks after interventions. Repeated measures analysis of variance and linear mixed models were used to examine between-group differences.
Results: A significant group×time interaction effect was found for pain (p=0.008), central sensitization inventory (p=0.002) and kinesiophobia (p<0.001) in the pain neuroscience education with targeted cognitive motor control training group compared to the targeted cognitive motor control training only group after eight weeks. Main effects of time were observed for pain, disability, and fear of movement after interventions (p<0.001). No significant group×time interaction effects was found for disability (p=0.50).
Conclusions: This study’s findings support the provision of pain neuroscience education as a clinically effective addition to targeted cognitive motor control training in chronic low back pain patients.

Keywords: Low Back Pain, Pain Neuroscience Education, Exercise Therapy, Kinesiophobia.

Full-Text [PDF 695 kb] (322 Downloads)

Type of Study: Research | Subject: آسیب شناسی و حرکات اصلاحی
Received: 2023/07/25 | Accepted: 2023/12/25 | Published: 2024/08/31

References

1. Saragiotto BT, Maher CG, Yamato TP, Costa LO, Menezes Costa LC, Ostelo RW, et al. Motor control exercise for chronic non-specific low-back pain. The Cochrane database of systematic reviews. 2016;2016(1):Cd012004. [DOI:10.1136/bjsports-2016-097266]

2. Tschudi-Madsen H, Kjeldsberg M, Natvig B, Ihlebaek C, Dalen I, Kamaleri Y, et al. A strong association between non-musculoskeletal symptoms and musculoskeletal pain symptoms: results from a population study. BMC musculoskeletal disorders. 2011;12(1):285. [DOI:10.1186/1471-2474-12-285]

3. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological bulletin. 2007;133(4):581. [DOI:10.1037/0033-2909.133.4.581]

4. Keller A, Hayden J, Bombardier C, Van Tulder M. Effect sizes of non-surgical treatments of non-specific low-back pain. European Spine Journal. 2007;16:1776-88. [DOI:10.1007/s00586-007-0379-x]

5. Malfliet A, Kregel J, Coppieters I, De Pauw R, Meeus M, Roussel N, et al. Effect of pain neuroscience education combined with cognition-targeted motor control training on chronic spinal pain: a randomized clinical trial. JAMA neurology. 2018;75(7):808-17. [DOI:10.1001/jamaneurol.2018.0492]

6. Malfliet A, Kregel J, Meeus M, Cagnie B, Roussel N, Dolphens M, et al. Applying contemporary neuroscience in exercise interventions for chronic spinal pain: treatment protocol. Brazilian journal of physical therapy. 2017;21(5):378-87. [DOI:10.1016/j.bjpt.2017.06.019]

7. Malfliet A, Kregel J, Meeus M, Roussel N, Danneels L, Cagnie B, et al. Blended-learning pain neuroscience education for people with chronic spinal pain: randomized controlled multicenter trial. Physical Therapy. 2018;98(5):357-68. [DOI:10.1093/ptj/pzx092]

8. Tegner H, Frederiksen P, Esbensen BA, Juhl C. Neurophysiological pain education for patients with chronic low back pain. The Clinical journal of pain. 2018;34(8):778-86. [DOI:10.1097/AJP.0000000000000594]

9. Wood L, Hendrick PA. A systematic review and meta‐analysis of pain neuroscience education for chronic low back pain: Short‐and long‐term outcomes of pain and disability. European Journal of Pain. 2019;23(2):234-49. [DOI:10.1002/ejp.1314]

10. Tracey I, Mantyh PW. The cerebral signature for pain perception and its modulation. Neuron. 2007;55(3):377-91. [DOI:10.1016/j.neuron.2007.07.012]

11. Nijs J, Van Wilgen CP, Van Oosterwijck J, van Ittersum M, Meeus M. How to explain central sensitization to patients with 'unexplained'chronic musculoskeletal pain: practice guidelines. Manual therapy. 2011;16(5):413-8. [DOI:10.1016/j.math.2011.04.005]

12. Pires D, Cruz EB, Caeiro C. Aquatic exercise and pain neurophysiology education versus aquatic exercise alone for patients with chronic low back pain: a randomized controlled trial. Clinical rehabilitation. 2015;29(6):538-47. [DOI:10.1177/0269215514549033]

13. Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. The Journal of Pain. 2015;16(9):807-13. [DOI:10.1016/j.jpain.2015.05.005]

14. Alves SM, Puentedura EJ, Silva AG. Pain neuroscience education and graded exposure versus Pilates and postural education: A pilot study in an occupational context. Physiotherapy theory and practice. 2022:1-12. [DOI:10.1080/09593985.2022.2122914]

15. Pardo GB, Girbés EL, Roussel NA, Izquierdo TG, Penick VJ, Martín DP. Pain neurophysiology education and therapeutic exercise for patients with chronic low back pain: a single-blind randomized controlled trial. Archives of physical medicine and rehabilitation. 2018;99(2):338-47. [DOI:10.1016/j.apmr.2017.10.016]

16. Rabiei P, Sheikhi B, Letafatkar A. Comparing Pain Neuroscience Education Followed by Motor Control Exercises With Group‐Based Exercises for Chronic Low Back Pain: A Randomized Controlled Trial. Pain Practice. 2021;21(3):333-42. [DOI:10.1111/papr.12963]

17. O'Keeffe M, Hayes A, McCreesh K, Purtill H, O'Sullivan K. Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis. British journal of sports medicine. 2017;51(2):126-32. [DOI:10.1136/bjsports-2015-095410]

18. Roussel N, Nijs J, Truijen S, Vervecken L, Mottram S, Stassijns G. Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study. European Spine Journal. 2009;18:1066-73. [DOI:10.1007/s00586-009-1020-y]

19. Roussel N, De Kooning M, Schutt A, Mottram S, Truijen S, Nijs J, et al. Motor control and low back pain in dancers. International journal of sports medicine. 2012:138-43. [DOI:10.1055/s-0032-1321722]

20. Scrimshaw SV, Maher C. Responsiveness of visual analogue and McGill pain scale measures. Journal of manipulative and physiological therapeutics. 2001;24(8):501-4. [DOI:10.1067/mmt.2001.118208]

21. Zanoli G, Strömqvist B, Jönsson B, Padua R, Romanini E. Pain in low-back pain: Problems in measuring outcomes in musculoskeletal disorders. Acta Orthopaedica Scandinavica. 2002;73(sup305):54-7. [DOI:10.1080/000164702760379576]

22. Grönblad M, Järvinen E, Hurri H, Hupli M, Karaharju EO. Relationship of the Pain Disability Index (PDI) and the Oswestry Disability Questionnaire (ODQ) with three dynamic physical tests in a group of patients with chronic low-back and leg pain. The Clinical journal of pain. 1994;10(3):197-203. [DOI:10.1097/00002508-199409000-00005]

23. Park KB, Shin J-S, Lee J, Lee YJ, Kim M-r, Lee J-H, et al. Minimum Clinically Important Difference and Substantial Clinical Benefit in Pain, Functional, and Quality of Life Scales in Failed Back Surgery Syndrome Patients. Spine. 2017;42(8):E474-E81. [DOI:10.1097/BRS.0000000000001950]

24. Mayer TG, Neblett R, Cohen H, Howard KJ, Choi YH, Williams MJ, et al. The development and psychometric validation of the central sensitization inventory. Pain Practice. 2012;12(4):276-85. [DOI:10.1111/j.1533-2500.2011.00493.x]

25. Bid Dibyendunarayan D, Soni Neela C, Rathod Priyanshu V, Thangamani Ramalingam A. Content validity and test-retest reliability of the Gujarati version of the central sensitization inventory. Natl J Integr Res Med. 2016;7(5):18-24.

26. Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a self-management program on patients with chronic disease. Effective clinical practice: ECP. 2001;4(6):256-62.

27. Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain. 2005;117(1-2):137-44. [DOI:10.1016/j.pain.2005.05.029]

28. Stratford PW, Binkley J, Solomon P, Gill C, Finch E. Assessing change over time in patients with low back pain. Physical Therapy. 1994;74(6):528-33. [DOI:10.1093/ptj/74.6.528]

29. Nijs J, Meeus M, Cagnie B, Roussel NA, Dolphens M, Van Oosterwijck J, et al. A modern neuroscience approach to chronic spinal pain: combining pain neuroscience education with cognition-targeted motor control training. Physical therapy. 2014;94(5):730-8. [DOI:10.2522/ptj.20130258]

30. Løchting I, Storheim K, Werner E, Cvancarova MS, Grotle M. Evaluation of individualized quality of life and illness perceptions in low back pain. A patient education cluster randomized controlled trial. Patient Education and Counseling. 2016;99(12):1992-8. [DOI:10.1016/j.pec.2016.05.015]

31. Werner EL, Storheim K, Løchting I, Wisløff T, Grotle M. Cognitive patient education for low back pain in primary care: a cluster randomized controlled trial and cost-effectiveness analysis. LWW; 2016. [DOI:10.1097/BRS.0000000000001268]

32. Téllez-García M, de-la-Llave-Rincón AI, Salom-Moreno J, Palacios-Ceña M, Ortega-Santiago R, Fernández-de-Las-Peñas C. Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial. Journal of bodywork and movement therapies. 2015;19(3):464-72. [DOI:10.1016/j.jbmt.2014.11.012]

33. Fletcher C, Bradnam L, Barr C. The relationship between knowledge of pain neurophysiology and fear avoidance in people with chronic pain: A point in time, observational study. Physiotherapy theory and practice. 2016;32(4):271-6. [DOI:10.3109/09593985.2015.1138010]