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

Publication date: Available online 11 November 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Bodes Pardo Gema., Lluch Girbés Enrique., Roussel Nathalie A., Gallego Izquierdo Tomás., Jiménez Penick Virginia., Pecos Martín Daniel.
AimTo assess the effect of a pain neurophysiology education program plus therapeutic exercise for patients with chronic low back pain (CLBP).DesignSingle-blind randomized controlled trial.SettingPrivate clinic (Clínica Bonn) and Alcalá de Henares University, Madrid, Spain.Participants56 patients with CLBP for 6 months or more.InterventionParticipants were randomized to receive either a therapeutic exercise (TE) program consisting of motor control, stretching, and aerobic exercises (TE group, n=28) or the same therapeutic exercise program in addition to a pain neurophysiology education program (PNE+TE group, n=28), conducted in two 30 to 50 minute sessions in groups of 4 to 6 participants.Main outcomes measuresThe primary outcome was pain intensity rated on the Numeric Pain Rating Scale which was completed immediately following treatment and at a 1-month 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 the Patient Global Impression of Change.ResultsAt the 3-month follow-up, a large change in pain intensity (-2.2 (-2.93,-1.28), p<0.001; d=1.37) was observed for the PNE+TE group, and a moderate effect size was observed for the secondary outcome measures.ConclusionCombining pain neurophysiology education plus therapeutic exercise resulted in significantly better results for participants with CLBP, with a large effect size, compared to therapeutic exercise alone.



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