Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial

Ponce-Fuentes, Felipe; Cuyúl-Vásquez, Iván; Bustos-Medina, Luis; Fuentes, Jorge

doi:10.1080/09593985.2022.2061394

Cited by 3 publications

(15 citation statements)

References 46 publications

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“…12 They found that either the PNE or biomedical education is equally effective in improving rest pain and disability, except for pain at movement in favor of the PNE group. 12 We found similar results as the PNE had no effect on pain and disability as both groups were improved with large effect sizes regardless of whether the PNE applied or not. The only difference was in pain intensity during activity, which could be resulted from the content and difference of treatment dosage between two studies as we applied five session instead Mean ± SD values for the continuous variables.…”

Section: Discussionmentioning

confidence: 98%

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Pain neuroscience education following arthroscopic rotator cuff repair for patients with rotator cuff tears: a double blind randomized controlled clinical trial

KARARTI,

ÖZYURT,

KODAK

et al. 2024

Am J Phys Med Rehabil

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Objective This trial examines the efficacy of the Pain Neuroscience Education (PNE) on clinical outcomes in patients with arthroscopic rotator cuff repair (ARCR). Design A total of 36 participants undergoing ARCR were assigned to either the experimental group (n = 18) or control group (n = 18) in this randomized study. A 6-week-long conventional physiotherapy program was administered for both groups. In addition, a PNE protocol was administered for the experimental group for a whole period of 6 weeks (one session/week, 15-60 min per session). The primary outcomes were to compare pre- and post-treatment scores of the experimental versus control groups on the pain and disability. Our secondary outcomes included the comparisons of scores on the catastrophizing, anxiety, depression, kinesiophobia, and quality of life. The participants were assessed both at baseline and post-treatment. Results The improvement in pain catastrophizing, anxiety, depression and kinesiophobia was greater in the experimental group (p < 0.05). The improvement was similar in both groups in terms of the rest of outcome measures. Conclusion This study showed that the PNE improved only psychological aspects of the chronic pain in ARCR. Therefore, adding PNE to the conventional program might be useful to improve pain catastrophizing, anxiety, depression and kinesiophobia in patients with ARCR.

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Section: Discussionmentioning

confidence: 98%

“…10 Considering these principles, the PNE seems to be a potential action mechanism in patients with ARCR. 11,12 Therefore, we aimed to examine the efficacy of the PNE on clinical outcomes in patients with ARCR. The primary outcomes were to compare pretreatment and posttreatment scores of the experimental versus control groups on the pain and disability.…”

mentioning

confidence: 99%

Pain neuroscience education following arthroscopic rotator cuff repair for patients with rotator cuff tears: a double blind randomized controlled clinical trial

KARARTI,

ÖZYURT,

KODAK

et al. 2024

Am J Phys Med Rehabil

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“…However, 5 participants (0.2%) had dropped out by the final question of the survey. Median (IQR) survey duration for those randomised was 15 minutes (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Characteristics were similar between the groups (Table 1).…”

Section: Flow Of Participants Through the Studymentioning

confidence: 96%

“…27 Two trials have evaluated the effects of pain neuroscience education added to rehabilitation after arthroscopic rotator cuff repair for rotator cuff-related shoulder pain, but the size of those trials (n 5 34 and 29) limits our confidence in their findings. 14,19 One trial found that pain neuroscience education had no effect on pain and function compared with no education, but it slightly improved fear avoidance beliefs. 14 The other found that pain neuroscience education had no effect on pain, function, catastrophizing, fear avoidance beliefs, and quality of life compared with biomedical education.…”

Section: Introductionmentioning

confidence: 99%

“…14 The other found that pain neuroscience education had no effect on pain, function, catastrophizing, fear avoidance beliefs, and quality of life compared with biomedical education. 19 Other trials have evaluated education for rotator cuff-related shoulder pain (eg, using patient decision aids 31 or brief messages 32 ), but overall, there is very limited evidence on their effects and on which type of education is most effective.…”

Section: Introductionmentioning

confidence: 99%

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Education can reassure people with rotator cuff–related shoulder pain: a 3-arm, randomised, online experiment

Zadro,

Ferreira,

Muller

et al. 2023

Pain

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We aimed to investigate the immediate effect of best practice education (with and without pain science messages) and structure-focused education on reassurance among people with rotator cuff–related shoulder pain. We conducted a 3-arm, parallel-group, randomised experiment. People with rotator cuff–related shoulder pain were randomised (1:1:1) to (1) best practice education (highlights that most shoulder pain is not serious or a good indicator of tissue damage and recommends simple self-management strategies); (2) best practice education plus pain science messages (which attempt to improve understanding of pain); and (3) structure-focused education (highlighting that structural changes are responsible for pain and should be targeted with treatment). Coprimary outcomes were self-reported reassurance that no serious condition is causing their pain and continuing with daily activities is safe. Secondary outcomes measured management intentions, credibility and relevance of the education, and similarity to previous education. Two thousand two hundred thirty-seven participants were randomised and provided primary outcome data. Best practice education increased reassurance that no serious condition is causing their pain (estimated mean effect 0.5 on a 0-10 scale, 95% confidence interval [CI] 0.2-0.7) and continuing with daily activities is safe (0.6, 95% CI 0.3-0.8) compared with structure-focused education. Adding pain science messages to best practice education slightly increased both measures of reassurance (0.2, 95% CI 0.0-0.4). Clinicians treating patients with rotator cuff–related shoulder pain should highlight that most shoulder pain is not serious or a good indicator of tissue damage and recommend simple self-management strategies. The benefit of adding pain science messages is small.

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A Call for Improving Research on Pain Neuroscience Education and Chronic Pain: An Overview of Systematic Reviews

Martínez-Calderón¹,

Ho²,

Ferreira³

et al. 2023

Journal of Orthopaedic & Sports Physical Therapy

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OBJECTIVE: We aimed to summarize the evidence of the effects of pain neuroscience education delivered alone or combined with other interventions for chronic pain. DESIGN: An overview of systematic reviews with meta-analysis. LITERATURE SEARCH: CINAHL (via EBSCOhost), Embase, PsycINFO (via ProQuest), PubMed, and the Cochrane Library were searched from their inception to November 14, 2022. STUDY SELECTION CRITERIA: Systematic reviews (SRs) with meta-analyses including randomized clinical trials. The outcomes were pain and psychological symptoms. DATA SYNTHESIS: AMSTAR 2 assessed the methodological quality of SRs. The primary study overlap was evaluated by calculating the corrected covered area (CCA). RESULTS: We included 8 SRs including 30 meta-analyses of interest that comprised 28 distinct clinical trials. In some meta-analyses, pain neuroscience education delivered alone or combined with other interventions was more effective than control interventions for reducing pain intensity, pain catastrophizing, kinesiophobia, anxiety symptoms, and depression symptoms at some time points. However, other meta-analyses found a lack of effects of pain neuroscience education, and there were inconsistencies between meta-analyses covering the same outcome. The methodological quality of all SRs was critically low. The overlap, including all SRs, was high (CCA = 13%), and very high for SRs covering trials on chronic low back pain (CCA = 40%), chronic spine pain (CCA = 27%), and fibromyalgia (CCA = 25%). CONCLUSION: It is impossible to make clear clinical recommendations for delivering pain neuroscience education based on current meta-analyses. Action is needed to increase and improve the quality of SRs in the field of pain neuroscience education. J Orthop Sports Phys Ther 2023;53(6):353–368. Epub: 10 May 2023. doi:10.2519/jospt.2023.11833

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Effects of pain neuroscience education and rehabilitation following arthroscopic rotator cuff repair. A randomized clinical trial

Cited by 3 publications

References 46 publications

Pain neuroscience education following arthroscopic rotator cuff repair for patients with rotator cuff tears: a double blind randomized controlled clinical trial

Pain neuroscience education following arthroscopic rotator cuff repair for patients with rotator cuff tears: a double blind randomized controlled clinical trial

Education can reassure people with rotator cuff–related shoulder pain: a 3-arm, randomised, online experiment

A Call for Improving Research on Pain Neuroscience Education and Chronic Pain: An Overview of Systematic Reviews

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