{"title":"A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-term outcomes of pain and disability.","authors":"Xiaopeng Ma, Ruohan Chen, Wei Li, Peng Huang","doi":"10.1080/09593985.2023.2232003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The evidence supporting the application of pain neuroscience education (PNE) in patients with chronic low back pain (LBP) remains some arguments.</p><p><strong>Objective: </strong>This review aims to investigate the effect of PNE alone and combined with physical therapy or exercise for chronic LBP.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and the Cochrane databases were searched from establishment to June 3, 2023. Randomized controlled trials (RCT) evaluating the effect of PNE in patients with chronic LBP were considered eligible. Data were analyzed using a random-effects model (I<sup>2</sup> >50%) or a fixed-effects model (I<sup>2</sup> <50%) and trials were appraised using the Cochrane ROB tool. Meta-regression was conducted to assess the moderator factors.</p><p><strong>Results: </strong>Seventeen studies (1078 participants) were included in this review. PNE plus exercise and PNE plus physiotherapy both showed a reduction of short-term pain (mean differences [MD] -1.14 [-1.55, -0.72]; MD -1.15 [-1.67, -0.64]) and disability (standardized mean difference [SMD] -0.80 [-1.13, -0.47]; SMD -0.85 [-1.29, -0.40]) than physiotherapy or exercise alone. Meta-regression showed that only single PNE session duration was associated with a greater reduction in pain (<i>P</i> < .05). Subgroup results showed that a single PNE session exceeding 60 minutes (MD -2.04), 4 to 8 sessions (MD -1.34), intervention for 7 to 12 weeks (MD -1.32), and a group-based approach (MD -1.76) may be more beneficial.</p><p><strong>Conclusion: </strong>This review indicates that adding PNE to treatment programs would lead to more efficacious effects for chronic LBP. Additionally, we preliminarily extracted dose-effect relationships for PNE intervention, providing guidance for clinicians to design effective PNE sessions.</p>","PeriodicalId":48699,"journal":{"name":"Physiotherapy Theory and Practice","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Theory and Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09593985.2023.2232003","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/3 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The evidence supporting the application of pain neuroscience education (PNE) in patients with chronic low back pain (LBP) remains some arguments.
Objective: This review aims to investigate the effect of PNE alone and combined with physical therapy or exercise for chronic LBP.
Methods: PubMed, Embase, Web of Science, and the Cochrane databases were searched from establishment to June 3, 2023. Randomized controlled trials (RCT) evaluating the effect of PNE in patients with chronic LBP were considered eligible. Data were analyzed using a random-effects model (I2 >50%) or a fixed-effects model (I2 <50%) and trials were appraised using the Cochrane ROB tool. Meta-regression was conducted to assess the moderator factors.
Results: Seventeen studies (1078 participants) were included in this review. PNE plus exercise and PNE plus physiotherapy both showed a reduction of short-term pain (mean differences [MD] -1.14 [-1.55, -0.72]; MD -1.15 [-1.67, -0.64]) and disability (standardized mean difference [SMD] -0.80 [-1.13, -0.47]; SMD -0.85 [-1.29, -0.40]) than physiotherapy or exercise alone. Meta-regression showed that only single PNE session duration was associated with a greater reduction in pain (P < .05). Subgroup results showed that a single PNE session exceeding 60 minutes (MD -2.04), 4 to 8 sessions (MD -1.34), intervention for 7 to 12 weeks (MD -1.32), and a group-based approach (MD -1.76) may be more beneficial.
Conclusion: This review indicates that adding PNE to treatment programs would lead to more efficacious effects for chronic LBP. Additionally, we preliminarily extracted dose-effect relationships for PNE intervention, providing guidance for clinicians to design effective PNE sessions.
期刊介绍：
The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.
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