A randomized controlled trial of intensive neurophysiology education in chronic low back pain

Moseley, GL, Nicholas, MK and Hodges, PW (2004) A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clinical Journal of Pain, 20 5: 324-330.


Author Moseley, GL
Nicholas, MK
Hodges, PW
Title A randomized controlled trial of intensive neurophysiology education in chronic low back pain
Journal name Clinical Journal of Pain   Check publisher's open access policy
ISSN 0749-8047
Publication date 2004
Sub-type Article (original research)
DOI 10.1097/00002508-200409000-00007
Volume 20
Issue 5
Start page 324
End page 330
Total pages 7
Editor D.C. Turk
Place of publication US
Publisher Lippincott, Williams & Wilkins
Collection year 2004
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730303 Occupational, speech and physiotherapy
Abstract Objectives: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. Methods: This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal drawing-in task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. Results: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. Discussion: Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.
Keyword Anesthesiology
Clinical Neurology
Education
Low Back Pain
Multidisciplinary Pain Management
Electrical Nerve-stimulation
Behavioral Group Treatment
Psychosocial Issues
Primary-care
School
Disability
Lumbar
Work
Prevention
Efficacy
Q-Index Code C1

 
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