A randomized controlled trial of intensive neurophysiology education in chronic low back pain
长期的腰骶部疼痛地的集中的神经生理学教育的使随机化的控制审判。作者机构：Royal Brisbane Hosp Dept Physiotherapy Herston Qld 4029 Australia
Univ Queensland Brisbane Qld Australia
Univ Sydney Pain Management & Res Ctr St Leonards NSW 2065 Australia
Royal N Shore Hosp St Leonards NSW 2065 Australia
出 版 物：《CLINICAL JOURNAL OF PAIN》 (疼痛临床杂志)
年 卷 期：2004年第20卷第5期
页 面：324-330
核心收录：
中图分类：R4[医药、卫生-临床医学]
学科分类：1006[医学-中西医结合] 1002[医学-临床医学] 100602[医学-中西医结合临床] 10[医学]
主 题：education low back pain multidisciplinary pain management
摘 要：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.
