Pain Neurophysiology Education and Exercise for Adolescents With Chronic Idiopathic Neck Pain

Pain Neurophysiology Education and Exercise for Adolescents With Chronic Idiopathic Neck Pain: a School-based Pilot, Randomised and Controlled Study

This study compared the effectiveness of pain neurophysiology education and neck/shoulder exercises with no intervention in adolescents with chronic idiopathic neck pain (CINP).

Study Overview

• Status: Completed
• Conditions: Neck Pain
• Intervention / Treatment: Other: neurophysiology of pain education and exercises

Detailed Description

Forty three adolescents with chronic idiopathic neck pain were randomly allocated to receive pain neurophysiology education and shoulder/neck exercises (n=21) or no intervention (n=22). Data on pain intensity (Visual Analogue Scale), pain disability, neck flexor and extensor muscles endurance, scapulae stabilizers endurance, pain catastrophizing (Pain catastrophizing Scale), trait and state anxiety (State-Trait Anxiety Inventory) and knowledge of pain neurophysiology (Neurophysiology of Pain Questionnaire) were collected. Measurements were taken before and after the intervention.

Statistical analysis were performed using a mixed-methods ANOVA.

• Study Type: Interventional
• Enrollment (Actual): 43
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 20 years (ADULT, CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• To be invited to enter the study participants had to have chronic idiopathic neck/shoulder pain, defined as pain felt in the neck/shoulder regions at least once a week in the previous 3 months.

Exclusion Criteria:

• No exclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Education and exercise; The intervention included neurophysiology of pain education and exercises.	Other: neurophysiology of pain education and exercises; Pain neurophysiology education covered the neurophysiology of pain, transition from acute to chronic pain and the nervous system ability to modulate the pain experience. It was delivered in small groups (4 to 7 participants). A total of 4 sessions were delivered over 4 weeks (1 session per week). Each session took between 45 minutes and 1 hour. Exercises were aimed at increasing the endurance and strength of the deep neck flexor and extensor muscles and of the scapular muscles delivered over 3 sessions (the first session covered pain neurophysiology education only). Each exercise was performed in 3 series of 10 repetitions. The number of exercises targeting the same group of muscles increased from one in the 2nd session to 2/3 in the 4th session.
NO_INTERVENTION: No intervention; This group received no intervention as participants were students that were not seeking treatment for their pain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Method of assessment - Visual analogue scale	At the beginning
Pain intensity	Method of assessment - Visual analogue scale	5 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck pain frequency	Method of assessment - a question on neck pain frequency in the previous week (never, seldom, occasionally, often, always)	At the beginning
Neck pain frequency	Method of assessment - a question on neck pain frequency in the previous week (never, seldom, occasionally, often, always)	5 weeks
Neck pain duration	Method of assessment - a question on neck pain duration (how long have you have neck pain?)	At the beginning
Neck pain duration	Method of assessment - a question on neck pain duration (how long have you have neck pain?)	5 weeks
Neck pain associated disability	Method of assessment - a disability index with 5 questions on neck pain associated disability	At the beginning
Neck pain associated disability	Method of assessment - a disability index with 5 questions on neck pain associated disability	5 weeks
Neck flexor muscles endurance test	Method of assessment - physical test; the participant is in supine and he/she is asked to flex the upper cervical spine, move their head away from the couch approximately 2.5 cm and then maintain this position for as long as possible. The test result is the time (in seconds) that each participant holds the position.	At the beginning
Neck flexor muscles endurance test	Method of assessment - physical test; the participant is in supine and he/she is asked to flex the upper cervical spine, move their head away from the couch approximately 2.5 cm and then maintain this position for as long as possible. The test result is the time (in seconds) that each participant holds the position.	5 weeks
Neck extensor muscles endurance test	Method of assessment - physical test; the participant is in prone and position, head neutral, and supporting 2 Kg weight hanging from it. Participants were asked to support this weight for as long as possible while maintaining the neutral head positioning. The test result is the time (in seconds) that each participant holds the position.	At the beginning
Neck extensor muscles endurance test	Method of assessment - physical test; the participant is in prone and position, head neutral, and supporting 2 Kg weight hanging from it. Participants were asked to support this weight for as long as possible while maintaining the neutral head positioning. The test result is the time (in seconds) that each participant holds the position.	5 weeks
Scapular stabilizers' endurance test	Method of assessment - physical test; Method of assessment - physical test; Participants were standing with the shoulders and elbows flexed at 90º, while pulling both extremities of a dynamometer to reach 1 Kg of force. The test result is the time (in seconds) that each participants was able to hold this position.	At the beginning
Scapular stabilizers' endurance test	Method of assessment - physical test; Method of assessment - physical test; Participants were standing with the shoulders and elbows flexed at 90º, while pulling both extremities of a dynamometer to reach 1 Kg of force. The test result is the time (in seconds) that each participants was able to hold this position.	5 weeks
State-trait anxiety inventory	Method of assessment - scale	At the beginning
State-trait anxiety inventory	Method of assessment - scale	5 weeks
Pain Catastrophizing Scale	Method of assessment - scale	At the beginning
Pain Catastrophizing Scale	Method of assessment - scale	5 weeks
Neurophysiology of pain questionnaire	Method of assessment - questionnaire	At the beginning
Neurophysiology of pain questionnaire	Method of assessment - questionnaire	5 weeks
Patients' Global Impression of Change	Method of assessment - scale	5 weeks

Collaborators and Investigators

• Sponsor: Aveiro University

Study record dates

Study Major Dates

• Study Start: March 1, 2015
• Primary Completion (ACTUAL): June 1, 2015
• Study Completion (ACTUAL): June 1, 2015

Study Registration Dates

• First Submitted: June 23, 2016
• First Submitted That Met QC Criteria: July 6, 2016
• First Posted (ESTIMATE): July 11, 2016

Study Record Updates

• Last Update Posted (ESTIMATE): July 11, 2016
• Last Update Submitted That Met QC Criteria: July 6, 2016
• Last Verified: July 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: PCEDCSS_FMUP 5/2015

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO