Gema Bodes Pardo1, Enrique Lluch Girbés2, Nathalie A Roussel3, Tomás Gallego Izquierdo4, Virginia Jiménez Penick1, Daniel Pecos Martín4. 1. Clínica Bonn, Madrid, Spain. 2. Department of Physical Therapy, University of Valencia, Valencia, Spain; Pain in Motion Research Group; Department of Human Physiology (Chropiver), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel. Electronic address: quilluch@hotmail.com. 3. Department of Human Physiology (Chropiver), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk; Department of Health Care Sciences, Division of Musculoskeletal Physiotherapy (Chropiver), Artesis University College, Antwerp. 4. Department of Physical Therapy of Universidad de Alcalá, Spain.
Abstract
OBJECTIVE: To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). DESIGN: Single-blind randomized controlled trial. SETTING:Private clinic and university. PARTICIPANTS: Patients with CLBP for ≥6 months (N=56). INTERVENTIONS: Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants. MAIN OUTCOMES MEASURES: The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1- and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Patient Global Impression of Change. RESULTS: At 3-month follow-up, a large change in pain intensity (numerical pain rating scale: -2.2; -2.93 to -1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures. CONCLUSIONS: Combining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone.
RCT Entities:
OBJECTIVE: To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP). DESIGN: Single-blind randomized controlled trial. SETTING: Private clinic and university. PARTICIPANTS: Patients with CLBP for ≥6 months (N=56). INTERVENTIONS:Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants. MAIN OUTCOMES MEASURES: The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1- and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Patient Global Impression of Change. RESULTS: At 3-month follow-up, a large change in pain intensity (numerical pain rating scale: -2.2; -2.93 to -1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures. CONCLUSIONS: Combining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone.
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