Effects of Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students

June 3, 2025 updated by: Hatice Gül, Akdeniz University

Effects of Traditional Pain Education and Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students

The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. The main questions this study aims to answer are:

Does a single-session PNE-based education improve students' beliefs about the relationship between pain and disability? Does it reduce reliance on biomedical (organic) pain beliefs compared to traditional pain education? In this study, researchers will compare PNE-based education to traditional pain education, both delivered through 70-minute lectures.

Participants were randomly assigned to either the PNE group or the traditional education group, attended a one time 70-minute classroom lecture, completed questionnaires at three time points: before the session, immediately after, and 3 months later.

The main tools used will be the Health Care Providers' Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Pain Beliefs Questionnaire (PBQ), which includes organic and psychological subscales.

This study aims to support the integration of contemporary pain neuroscience content into physiotherapy assistant curricula to enhance biopsychosocial understanding at an early stage of professional education.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

In Turkey, research on the impact of pain neuroscience education (PNE) on the knowledge, beliefs, and attitudes of undergraduate physiotherapy students remains scarce. Moreover, there appears to be no study that directly contrasts traditional pain education with a PNE-based approach that conceptualizes pain as an outcome-driven process, enriched with metaphors and storytelling. Existing literature suggests that physiotherapy assistant programs often provide limited exposure to neuroscience content, which may contribute to the lack of significant improvements in students' understanding and attitudes toward pain following PNE.

Against this background, the current study was developed to explore how a metaphor-supported, case-based PNE intervention influences the pain-related knowledge and beliefs of physiotherapy assistant students. To the best of our knowledge, no prior study in Turkey has systematically evaluated the effects of PNE within this specific student group. Therefore, a randomized controlled trial was designed to compare the outcomes of traditional structural pain education and a neuroscience-based educational program on pain-related beliefs and attitudes among physiotherapy assistant students.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
41

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Konyaaltı
      • Antalya, Konyaaltı, Turkey, 07070
        • Akdeniz University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Students were eligible to participate if they were undergraduate physiotherapy assistant students enrolled at the Vocational School of Health Services.

Exclusion Criteria:

  • Individuals were excluded if they had previously received in-depth teaching on pain neurophysiology or traditional pain education.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Traditional Pain Education
Participants in the control group received a 70-minute lecture based on the biomedical model of pain.
Other: Traditional pain education
Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury.
Experimental: PNE based education
Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain.
Other: PNE-based education

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors.

Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
The Health Care Pain Attitudes and Impairment Relationship Scale
Time Frame: Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.
The HC-PAIRS is a 12-item scale that measures healthcare providers' beliefs about how much pain leads to disability in low back pain cases, using a 7-point Likert scale. Higher scores indicate more negative attitudes. The Turkish version was validated and showed strong reliability (ICC = 0.85).
Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Pain Beliefs Questionnaire
Time Frame: Participants completed the Pain Beliefs Questionnaire at baseline, Day 1 and 3 months
The Pain Beliefs Questionnaire (PBQ) is a 12-item tool designed to assess individuals' beliefs about pain, divided into two subscales: Organic (8 items) and Psychological (4 items). The Organic subscale reflects beliefs about the physical causes of pain, while the Psychological subscale focuses on the influence of emotional and mental states such as anxiety and relaxation. Items are rated on a 6-point scale ranging from "always" to "never." Subscale scores are calculated by summing the relevant items. The PBQ can be used with healthy individuals and has been shown to have valid and reliable psychometric properties in its Turkish version.
Participants completed the Pain Beliefs Questionnaire at baseline, Day 1 and 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Akdeniz University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Pamukkale University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Hatice Gül, Akdeniz University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 12, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 12, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 12, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 26, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 3, 2025

First Posted (Estimated)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 5, 2025

Study Record Updates

Last Update Posted (Estimated)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 5, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 3, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 03.10.2024, TBAEK-683

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Since the dataset includes personal data, it is not planned to be shared.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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