• Pain Pract · Mar 2021

    Randomized Controlled Trial Comparative Study

    Comparing pain neuroscience education followed by motor control exercises with group-based exercises for chronic low back pain: a randomized controlled trial.

    • Pouya Rabiei, Bahram Sheikhi, and Amir Letafatkar.
    • Department of Physical Education and Sports Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran.
    • Pain Pract. 2021 Mar 1; 21 (3): 333-342.

    BackgroundDifferent individualized interventions have been used to improve chronic low back pain (CLBP). However, their superiority over group-based interventions has yet to be elucidated. We compared an individualized treatment involving pain neuroscience education (PNE) plus motor control exercise (MCE) with group-based exercise (GE) in patients with CLBP.MethodsSeventy-three patients with CLBP were randomly assigned into the PNE plus MCE group (n = 37) and GE group (n = 36). Both PNE plus MCE and GE were administered twice weekly for 8 weeks. Pain intensity (as measured using the VAS), disability (as measured using the Roland-Morris Disability Questionnaire), fear-avoidance beliefs (as measured using the Fear-Avoidance Beliefs Questionnaire), and self-efficacy (as measured using the Pain Self-Efficacy Questionnaire) were assessed at baseline and 8 weeks post-intervention. A 2 × 2 variance analysis (treatment group × time) with a mixed-model design was applied to statistically analyze the data.ResultsBoth groups showed significant improvements in all the outcome measures, with a large effect size (P < 0.001, partial eta squared [ηp2 ] = 0.66 to 0.81) after the intervention. The PNE plus MCE group showed greater improvements, with a moderate effect size in pain intensity (P = 0.041, ηp2  = 0.06) and disability (P = 0.021, ηp2  = 0.07) compared to the GE group. No significant difference was found in fear-avoidance beliefs during physical activity and work, and self-efficacy (P > 0.05) between the 2 groups.ConclusionPNE and 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. With regard to the superiority of individualized interventions over group-based ones, more studies are warranted.© 2020 World Institute of Pain.

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