Pain Neuroscience Education for Depression
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- St. Ambrose University
- Enrollment
- 30
- Locations
- 2
- Primary Endpoint
- Patient Health Questionnaire - PHQ-9
Study Overview
Brief Summary
This study will look at the effects of Pain Neuroscience Education on a Depression outcome tool in patients with chronic low back pain.
Detailed Description
Pain and depression have been shown to be interrelated, especially chronic pain: people in chronic pain develop depression and people with depression develop chronic pain. In light of this coexistence it is not surprising that current best-evidence for depression and chronic pain shows significant overlap which includes primarily some type of cognitive intervention, aerobic exercise, and skilled delivery of medication including selective-serotonin-reuptake-inhibitors and/or membrane stabilizers. Current best-evidence regarding musculoskeletal pain provides strong support for Pain Neuroscience Education (PNE) to positively influence pain ratings, dysfunction, and limitations in movement, pain knowledge and healthcare utilization. Additionally, PNE has shown to powerfully influence psychosocial issues that powerfully influence pain and depression: fear-avoidance and pain catastrophization. Evidence is lacking in whether PNE could also influence depression ratings. The purpose of this study is to examine the immediate effect of PNE on pain, function, and depressive symptoms (using the Patient Health Questionnaire - PHQ-9) in patients attending PT for chronic low back pain (LBP).
This will be a pre- and post-intervention convenience sample of consecutive patients with chronic LBP (pain > 6 months) meeting the inclusion criteria, attending outpatient PT. On initial examination, intake data and information will be collected prior to PNE and immediately following PNE.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Masking Description
No other parties will be masked.
Eligibility Criteria
- Ages
- 18 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •adults over the age of 18
- •presenting at PT with a primary complaint of LBP
- •LBP being present for 6 months or more
- •fluent in English
- •willing to participate in the study.
Exclusion Criteria
- •are under age 18 (minor)
- •had undergone lumbar surgery
- •cannot read or understand the English language
- •presents with any cognitive deficits rendering them unsuitable for PNE (i.e., stroke, traumatic brain injury, etc.)
- •decline to participate
- •present with a medical etiology (red flag) associated with their LBP.
Outcomes
Primary Outcomes
Patient Health Questionnaire - PHQ-9
Time Frame: within a single, 90 minute session
The PHQ-9 is the nine item depression scale
Pain Catastrophization Scale
Time Frame: within a single, 90 minute session
The PCS is a self-report questionnaire assessing inappropriate coping strategies and catastrophic thinking about pain and injury. on a 13-item, 5-point Likert scale with higher scores indicating elevated levels of catastrophizing.
revised Pain Neurophysiology Questionnaire - rNPQ
Time Frame: within a single, 90 minute session
The NPQ measures the neurophysiology knowledge of patients and healthcare personnel. The original NPQ is a 19-item questionnaire requesting 'true'; 'false'; or 'not sure' answers to statements, with higher scores indicating more correct answers.
Low back pain rating
Time Frame: within a single, 90 minute session
Numeric Pain Rating Scale for Back Pain (0 = no pain and 10 = worst pain). The minimal detectable change (MDC) for the NPRS for low back pain is reported to be 2.0.
Secondary Outcomes
No secondary outcomes reported
Investigators
Kevin Farrell
Professor and Chair, Orthopaedic Residency Program in Physical Therapy
St. Ambrose University