Effectiveness of Adding a Pain Neuroscience Education Program to a Multimodal Physiotherapy Intervention in Patients with Chronic Shoulder Pain: A Randomized Clinical Trial

在慢性肩痛患者的多模式物理治疗干预中加入疼痛神经科学教育计划的有效性:一项随机临床试验

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Abstract

Objectives: The purpose of this study was to assess the efficacy of a pain neuroscience education program completed by patients with shoulder pain. Methods: A randomized, controlled trial was performed. Fifty-five patients satisfied the eligibility criteria, agreed to participate, and were randomized into an experimental group (n = 27) or control group (n = 28). A manual therapy and exercises program was administered for both groups. The experimental group also received a 4-week pain neuroscience education protocol (1 session/week, 75 min per session). The measurements taken included the active range of motion, pain, disability, catastrophizing, kinesiophobia, and therapeutic alliance. The outcomes were assessed at baseline and 5 weeks after completion of treatment. The primary outcome analyzed was the group × time interaction. Results: The 2 × 2 analysis of variance revealed a significant group × time interaction for the active range of motion (F = 15.27; p = 0.011), disability (F = 6.14; p = 0.01), catastrophizing (F = 8.79; p = 0.01), kinesiophobia (F = 7.62; p = 0.008), and therapeutic alliance (p = 0.03) in favor of the experimental group. Conclusions: This study showed that the patients with shoulder pain who completed the pain neuroscience program achieved significantly better results in terms of their active range of motion, disability, catastrophizing, kinesiophobia, and therapeutic alliance compared to those achieved by the control group. Therefore, pain neuroscience education may be beneficial in the treatment of patients with shoulder pain.

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