Anneleen Malfliet1, Thomas Bilterys2, Eveline Van Looveren3, Mira Meeus4, Lieven Danneels4, Kelly Ickmans5, Barbara Cagnie4, Olivier Mairesse6, Daniel Neu7, Maarten Moens8, Dorien Goubert3, Steven J Kamper9, Jo Nijs5. 1. Research Foundation - Flanders (FWO), Brussels, Belgium; Pain in Motion International Research Group(1); Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, Ghent, Belgium. Electronic address: Anneleen.Malfliet@vub.be. 2. Pain in Motion International Research Group(1); Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium. 3. Pain in Motion International Research Group(1); Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, Ghent, Belgium. 4. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans, Ghent, Belgium. 5. Pain in Motion International Research Group(1); Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels Belgium. 6. Department of Experimental and Applied Psychology, Vrije Universiteit Brussel, Brussels, Belgium; Sleep Laboratory and Unit for Chronobiology U78, Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium. 7. Sleep Laboratory and Unit for Chronobiology U78, Brugmann University Hospital, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium. 8. Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium. 9. School of Public Health, University of Sydney, Camperdown, Australia; Centre for Pain, Health and Lifestyle, Sydney, Australia(2).
Abstract
BACKGROUND:Insomnia is a highly prevalent and debilitating comorbidity that is often not addressed in therapy for chronic spinal pain (CSP). Given the close interaction between insomnia and CSP severity and related disability, targeting sleep problems during therapy could improve treatment outcomes in these patients. OBJECTIVE: Can cognitive behavioral therapy for insomnia (CBT-I) combined with the modern neuroscience approach (i.e. pain neuroscience education and cognition-targeted exercise therapy) reduce pain and improve sleep, physical activity and function in people with CSP and comorbid insomnia? METHODS:Participants: One-hundred-twenty participants with chronic spinal pain and comorbid insomnia Intervention: CBT-I combined with the modern neuroscience approach (experimental) compared to the modern neuroscience approach alone (control). Both interventions start with three sessions of pain neuroscience education, followed by six sessions of CBT-I and nine sessions of cognition-targeted exercise therapy in the experimental group, or 15 sessions of cognition-targeted exercise therapy in the control group. MEASUREMENTS: Primary outcome measure: self-reported pain severity (Brief Pain Inventory). SECONDARY OUTCOME MEASURES: pain sensitivity (pressure pain thresholds, and online questionnaires), sleep-related outcomes (home-based polysomnography and online questionnaires), physical activity (actigraphy), and function (online questionnaires). Online questionnaires will be completed at baseline, directly post-treatment, and at 3, 6 and 12 months post-treatment. Polysomnography, pressure pain thresholds and actigraphy will be carried out at baseline, post-treatment and at 12 months follow-up. DISCUSSION: Findings may provide (1) a novel therapeutic approach for people with CSP and comorbid insomnia to improve pain, sleep, physical activity and function, and (2) new treatment guidelines for professionals. TRIAL REGISTRATION: Clinicaltrials.gov NCT03482856 (https://clinicaltrials.gov/ct2/show/NCT03482856).
RCT Entities:
BACKGROUND:Insomnia is a highly prevalent and debilitating comorbidity that is often not addressed in therapy for chronic spinal pain (CSP). Given the close interaction between insomnia and CSP severity and related disability, targeting sleep problems during therapy could improve treatment outcomes in these patients. OBJECTIVE: Can cognitive behavioral therapy for insomnia (CBT-I) combined with the modern neuroscience approach (i.e. pain neuroscience education and cognition-targeted exercise therapy) reduce pain and improve sleep, physical activity and function in people with CSP and comorbid insomnia? METHODS:Participants: One-hundred-twenty participants with chronic spinal pain and comorbid insomnia Intervention: CBT-I combined with the modern neuroscience approach (experimental) compared to the modern neuroscience approach alone (control). Both interventions start with three sessions of pain neuroscience education, followed by six sessions of CBT-I and nine sessions of cognition-targeted exercise therapy in the experimental group, or 15 sessions of cognition-targeted exercise therapy in the control group. MEASUREMENTS: Primary outcome measure: self-reported pain severity (Brief Pain Inventory). SECONDARY OUTCOME MEASURES: pain sensitivity (pressure pain thresholds, and online questionnaires), sleep-related outcomes (home-based polysomnography and online questionnaires), physical activity (actigraphy), and function (online questionnaires). Online questionnaires will be completed at baseline, directly post-treatment, and at 3, 6 and 12 months post-treatment. Polysomnography, pressure pain thresholds and actigraphy will be carried out at baseline, post-treatment and at 12 months follow-up. DISCUSSION: Findings may provide (1) a novel therapeutic approach for people with CSP and comorbid insomnia to improve pain, sleep, physical activity and function, and (2) new treatment guidelines for professionals. TRIAL REGISTRATION: Clinicaltrials.gov NCT03482856 (https://clinicaltrials.gov/ct2/show/NCT03482856).
Authors: Rajesh Khanna; Aubin Moutal; Katherine A White; Aude Chefdeville; Pedro Negrao de Assis; Song Cai; Vicki J Swier; Shreya S Bellampalli; Marissa D Giunta; Benjamin W Darbro; Dawn E Quelle; Jessica C Sieren; Margaret R Wallace; Christopher S Rogers; David K Meyerholz; Jill M Weimer Journal: Pain Date: 2019-11 Impact factor: 7.926
Authors: Lynn Leemans; Ömer Elma; Jo Nijs; Timothy H Wideman; Carolie Siffain; Hester den Bandt; Sven Van Laere; David Beckwée Journal: Braz J Phys Ther Date: 2020-05-12 Impact factor: 3.377