Pain Neuroscience Education and Exercise

Pain Neuroscience Education and Exercise Versus Exercise for University Students With Chronic Idiopathic Neck Pain: a Randomized, Controlled and Single Blind Study

This study examined the effects of pain neuroscience education plus exercise when compared with exercise only in university students with chronic idiopathic neck pain.

Study Overview

• Status: Completed
• Conditions: Neck Pain
• Intervention / Treatment: Other: Exercise; Other: Pain neuroscience education

Detailed Description

This study examined the effects of pain neuroscience education plus exercise when compared with exercise only in university students with chronic idiopathic neck pain.

University students with chronic neck pain were randomly allocated to receive pain neuroscience education and exercise or exercise only and assessed at baseline, after the intervention and at 3 months follow up. Outcome variables were pain intensity (primary outcome), disability, fear of movement, catastrophizing, knowledge of pain neurophysiology, pressure pain thresholds and neck and scapular muscle endurance.

• Study Type: Interventional
• Enrollment (Actual): 52
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participants could enter the study if they had chronic idiopathic neck pain, defined as pain felt in the neck at least once a week in the previous 3 months and for which no cause had been established. Furthermore, they were required to have a minimum pain intensity in the previous week of 2 in the visual analogue scale.

Exclusion Criteria:

• Participants were excluded if they had had physiotherapy for their neck pain in the 6 months previous to the study, if they had rheumatic, nervous, cardiac and/or respiratory pathology that could prevent or make it difficult to do the exercises. Exclusion criteria were ascertained by self-report.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: pain neuroscience education and exercise; This group received pain neuroscience education and exercise once a week over 4 weeks	Other: Exercise; Exercises were aimed at increasing the endurance and strength of the deep neck flexor and extensor muscles and of the scapular stabilizer muscles.; Other: Pain neuroscience education; Pain neuroscience education covered the neurophysiology of pain, transition from acute to chronic pain and the nervous system ability to modulate the pain experience.
Active Comparator: Exercise; This group received exercise directed at the neck and shoulder regions once a week over 4 weeks	Other: Exercise; Exercises were aimed at increasing the endurance and strength of the deep neck flexor and extensor muscles and of the scapular stabilizer muscles.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Measured using the visual analogue scale	At the beginning
Pain intensity	Measured using the visual analogue scale	5 weeks
Pain intensity	Measured using the visual analogue scale	At 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Deep neck flexor endurance	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
Deep neck flexor endurance	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 extensors endurance	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 extensors endurance	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	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	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
Pressure pain thresholds	Method of assessment - psychophysical test; Pressure was applied over the trapezius and at C5-C6 with a algometer until the participant first felt pain. The results was the quantity of force (in Kgf) supported by participants.	At the beginning
Pressure pain thresholds	Method of assessment - psychophysical test; Pressure was applied over the trapezius and at C5-C6 with a algometer until the participant first felt pain. The results was the quantity of force (in Kgf) supported by participants.	5 weeks
Disability	Method of assessment - the neck pain disability index	At the beginning
Disability	Method of assessment - the neck pain disability index	5 weeks
Disability	Method of assessment - the neck pain disability index	3 months
catastrophizing	Method of assessment - Pain catastrophising scale	at beginning
catastrophizing	Method of assessment - Pain catastrophising scale	5 weeks
catastrophizing	Method of assessment - Pain catastrophising scale	3 months
fear of movement	method of assessment - the Tampa Scale	At the beginning
fear of movement	method of assessment - the Tampa Scale	5 weeks
fear of movement	method of assessment - the Tampa Scale	3 months
Knowledge of pain neurophysiology	method of assessment - scale; the neurophysiology of pain questionnaire	at beginning
Knowledge of pain neurophysiology	method of assessment - scale; the neurophysiology of pain questionnaire	5 weeks
Knowledge of pain neurophysiology	method of assessment - scale; the neurophysiology of pain questionnaire	3 months

Collaborators and Investigators

• Sponsor: Aveiro University
• Investigators: Principal Investigator: Anabela Silva, PhD, University of Aveiro

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2015
• Primary Completion (Actual): February 28, 2016
• Study Completion (Actual): October 30, 2016

Study Registration Dates

• First Submitted: November 28, 2017
• First Submitted That Met QC Criteria: December 4, 2017
• First Posted (Actual): December 5, 2017

Study Record Updates

• Last Update Posted (Actual): December 5, 2017
• Last Update Submitted That Met QC Criteria: December 4, 2017
• Last Verified: December 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: PCEDCSS-FMUP 18

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No