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Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial

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Unit for Active Coping Strategies for Pain in Primary Care, East-Valladolid Primary Care Management, Castilla and León Public Health System (Sacyl), 47011 Valladolid, Spain
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Doctoral Program of Research in Health Sciences, University of Valladolid, 47005 Valladolid, Spain
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Department of Physical Therapy, University of Valencia, 46010 Valencia, Spain
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Pain in Motion International Research Group, 1090 Brussels, Belgium
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Department of Human Physiology and Rehabilitation Sciences, Faculty of Physiotherapy, Vrije University Brussels, B-1050 Brussels, Belgium
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Castilla and León Regional Centre of Sports Medicine, (Sacyl), 47011 Valladolid, Spain
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Department of Statistics and Operational Research and IMUVA, University of Valladolid, 47005 Valladolid, Spain
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Department of Physiotherapy, Faculty of Heath Sciences, University of Malaga, 19071 Málaga, Spain
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Institute of Biomedical Research in Malaga. IBIMA, 29010 Málaga, Spain
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School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, QLD 4000, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 1201; https://doi.org/10.3390/jcm9041201
Received: 18 March 2020 / Revised: 17 April 2020 / Accepted: 19 April 2020 / Published: 22 April 2020
(This article belongs to the Section Anesthesiology)
Chronic musculoskeletal pain affects more than 20% of the population, leading to high health care overload and huge spending. The prevalence is increasing and negatively affects both physical and mental health, being one of the leading causes of disability. The most common location is the spine. Most treatments used in the Public Health Services are passive (pharmacological and invasive) and do not comply with current clinical guidelines, which recommend treating pain in primary care (PC) with education and exercise as the first-line treatments. A randomized multicentre clinical trial has been carried out in 12 PC centres. The experimental group (EG) conducted a program of pain neuroscience education (6 sessions, 10 h) and group physical exercise with playful, dual-tasking, and socialization-promoting components (18 sessions in 6 weeks, 18 h), and the control group performed the usual physiotherapy care performed in PC. The experimental treatment improved quality of life (d = 1.8 in physical component summary), catastrophism (d = 1.7), kinesiophobia (d = 1.8), central sensitization (d = 1.4), disability (d = 1.4), pain intensity (d = 3.3), and pressure pain thresholds (d = 2). Differences between the groups (p < 0.001) were clinically relevant in favour of the EG. Improvements post-intervention (week 11) were maintained at six months. The experimental treatment generates high levels of satisfaction. View Full-Text
Keywords: chronic pain; chronic spinal pain; pain neuroscience education; physical exercise; primary care; randomized controlled trial chronic pain; chronic spinal pain; pain neuroscience education; physical exercise; primary care; randomized controlled trial
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Galan-Martin, M.A.; Montero-Cuadrado, F.; Lluch-Girbes, E.; Coca-López, M.C.; Mayo-Iscar, A.; Cuesta-Vargas, A. Pain Neuroscience Education and Physical Therapeutic Exercise for Patients with Chronic Spinal Pain in Spanish Physiotherapy Primary Care: A Pragmatic Randomized Controlled Trial. J. Clin. Med. 2020, 9, 1201.

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