• Gema Bodes Pardo, Enrique Lluch Girbés, Nathalie A Roussel, Tomás Gallego Izquierdo, Virginia Jiménez Penick, and Pecos Martín Daniel D Department of Physical Therapy of Universidad de Alcalá, Spain..
• Clínica Bonn, Madrid, Spain.
• Arch Phys Med Rehabil. 2018 Feb 1; 99 (2): 338-347.

ObjectiveTo assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP).DesignSingle-blind randomized controlled trial.SettingPrivate clinic and university.ParticipantsPatients with CLBP for ≥6 months (N=56).InterventionsParticipants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (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 numerical pain rating scale which was completed immediately after treatment and at 1- 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 Patient Global Impression of Change.ResultsAt 3-month follow-up, a large change in pain intensity (numerical pain rating scale: -2.2; -2.93 to -1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures.ConclusionsCombining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone.Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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