Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Eligibility Criteria
2.2.1. Inclusion Criteria
2.2.2. Exclusion Criteria
2.3. Search Strategy
2.4. Data Extraction
2.5. Risk of Bias Assessment
2.6. Strategy for Data Synthesis
3. Results
3.1. Literature Search and Characteristics of the Included Trials
3.2. Methodological Risk of Bias Assessment
3.3. Carryover Effect of Pain Neuroscience Education for Patients with Chronic Low Back Pain
3.4. Total Carryover Effect of Pain Neuroscience Education on Pain Intensity
3.5. Total Carryover Effect of Pain Neuroscience Education on Pain Catastrophizing
3.6. Total Carryover Effect of Pain Neuroscience Education on Kinesiophobia
3.7. Total Effect of Pain Neuroscience Education on Pain Intensity According to Therapeutic Intensity
3.8. Publication Bias
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Participants (Sample Size) | Therapeutic Intensity | Outcome Measure | Author’s Conclusions |
---|---|---|---|---|
Galan-Martin et al., 2020 [11] | Non-specific chronic spinal pain (166) | Total intervention period = 6 weeks EG = 6 sessions of PNE (10 h), 18 sessions exercise (18 h, three sessions per week) CG = 15 sessions (15 h) usual physiotherapy treatment | Pain intensity = VAS Pain catastrophizing = PCS Kinesiophobia = TSK | PNE and PE-based playful, dual-tasking, and socialization-promoting components are most effective in improving quality of life improvement, reduction of pain, catastrophism, kinesiophobia, CS, and disability. |
Kohns et al., 2020 [20] | Low back pain (104) | Total intervention period = A single PPN session EG = A single PPN session lasting 20–25 min, used a 3 min instructional video CG = Single session of self-assessment of health-related behaviors, lasting 20–25 min, used an educational video. | Pain intensity = BPI | PPN helps patients learn about centralized pain and evaluate their risk factors for such pain. Moreover, this intervention resulted in some reduction in pain intensity in the short term, but not in the long term. |
Løchting et al., 2016 [32] | Low back pain (203) | EG = 30 min, one-on-one PNE once a week for 4 consecutive weeks CG = 30 min, one-on-one sessions of usual care once a week for 4 consecutive weeks | Pain catastrophizing = PCS | The Cognitive patient education programs did not lead to improvements in individuals’ quality of life and pain catastrophizing. Through cognitive interventions need to be researched further in order to strengthen the understanding of these constructs in LBP. |
Malfliet et al., 2018 [14] | Chronic spinal pain (120) | Total intervention period = 12 weeks EG = 3 sessions of PNE, 15 exercise sessions CG = 3 sessions of Traditional education, 15 exercise sessions | Pain intensity = NPRS Kinesiophobia = TSK Pain catastrophizing = PCS | Combining PNE with CTMCT can reduce pain and disability and improve mental and physical functioning and pain cognitions in people with nCSP. |
Bodes Pardo et al., 2018 [29] | Chronic low back pain (56) | Total intervention period = 3 months EG = 2 sessions of PNPE (30 to 50 min), TE (daily) CG = TE (daily) | Pain intensity = NPRS Kinesiophobia = TSK | Combining PNE with TE is more effective in reducing pain, disability, and pain catastrophizing for participants with CLBP, with a large effect size, compared with TE alone. |
Pires, Cruz and Caeiro, 2015 [30] | Chronic low back pain (62) | Total intervention period = 6 weeks EG = 2 Group sessions, 90 min each Aquatic program: 6 weeks, 2 session/week CG = 6 weeks program consisting of 12 session of aquatic exercise (30–50 min) | Pain intensity = VAS Kinesiophobia = TSK | PNE is a clinically effective addition to aquatic exercise. Further studies are necessary to better understand how pain neurophysiology education influences pain intensity and disability and to evaluate the long terms effects of this intervention on pain and disability. |
Rabiei, Sheikhi and Letafatkar, 2021 [33] | Chronic low back pain (73) | Total intervention period = twice weekly for 8 weeks EG = 3 educational sessions PNE, each lasting 30–60 min; MCE, 2 sessions a week for 8 weeks. CG = Group-based exercise (GE) program. Proposed sessions 2 times a week for 8 weeks, each session lasting 60 min. | Pain intensity = VAS Kinesiophobia = FABQ | Individual treatment involving PNE plus MCE seem to be better at reducing pain intensity and disability compared to GE, while no significant differences were observed for fear-avoidance beliefs and self-efficacy between the 2 groups in patients with CLBP. |
Saracoglu, Arik, Afsar and Gokpinar, 2022 [31] | Chronic low back pain (38) | Total intervention period = 4 weeks EG = MT (2 day/week, 30 min), PNE (each week, 40–45 min), HEP (3 day/week, 10 repititions) CG = MT (2 day/week, 30 min), HEP (3 day/week, 10 repetitions) | Pain intensity = NPRS Kinesiophobia = TSK | When compared to MT and HEP or HEP alone, the combination of PNE, MT, and HEP is associated with greater improvement in terms of pain intensity and kinesiophobia in the short (4 weeks) and midterm (12 weeks). |
Werner et al., 2016 [21] | Non-specific low back pain (216) | EG = 30 min. of one-to-one PNE sessions once a week for four consecutive weeks CG = 30 min. of one-to-one sessions of usual care once a week for four consecutive weeks | Pain intensity = NPRS | The equal improvement observed in both groups in our study suggests that patient education may be useful, but no clinical or health economic benefits as a result of adding a cognitive education program to usual treatment for patients with subacute and chronic LBP. |
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Shin, S.; Kim, H. Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis. Medicina 2023, 59, 1268. https://doi.org/10.3390/medicina59071268
Shin S, Kim H. Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis. Medicina. 2023; 59(7):1268. https://doi.org/10.3390/medicina59071268
Chicago/Turabian StyleShin, Seungwoo, and Hyunjoong Kim. 2023. "Carryover Effects of Pain Neuroscience Education on Patients with Chronic Lower Back Pain: A Systematic Review and Meta-Analysis" Medicina 59, no. 7: 1268. https://doi.org/10.3390/medicina59071268