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Arch Phys Med Rehabil. 2018 Feb;99(2):338-347. doi: 10.1016/j.apmr.2017.10.016. Epub 2017 Nov 11.

Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial.

Author information

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.

KEYWORDS:

Exercise therapy; Low back pain; Neuroscience; Rehabilitation

PMID:
29138049
DOI:
10.1016/j.apmr.2017.10.016
[Indexed for MEDLINE]

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