The Effect of Structured Pain Education on Pain and Performance Parameters in Patients With Chronic Low Back Pain
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Low Back Pain
- Sponsor
- Medipol University
- Enrollment
- 35
- Locations
- 1
- Primary Endpoint
- Change from baseline in the multidimensional measure of pain on the Short-Form McGill Pain Questionnaire at 3 weeks
- Last Updated
- 3 years ago
Overview
Brief Summary
The Effect of Structured Pain Education on Pain and Performance Parameters in Patients with Chronic Low Back Pain
The aim of this study is to compare the effects of only Low Load Motor Control Exercises and Pain Education in addition to these exercises on pain, performance, disability and psychological factors, and to present a generalizable pain education in patients with chronic low back pain. We think that DYMK exercises applied together with a general Pain Education given to the patients will provide more improvement on these factors.
The patients will be divided into 2 groups, as a pain training group and an exercise group, with 20 people in each group, in a randomized controlled manner. Only DYMK exercise training will be applied to the exercise group. In the pain training group, pain training will be applied in addition to the DYMK exercise training.
As an evaluation parameter to the participants; Numerical Rating Scale, Short-Form McGill Pain Questionnaire, Pain Catastrophizing Scale, Tampa Kinesiophobia Scale, Roland-Morris Disability Questionnaire, Pain Self-Efficacy Questionnaire, Passive Lumbar Extension Test, Finger-Place Test and Physical Performance Test Battery will be applied. Patients will be evaluated before the start of the study (T0) and at the end of the study (T1).
Low Load Motor Control Exercises will be applied to people in both groups for 4 weeks, 3 days a week, during 20-30 minute sessions. In addition to the DYMK exercise training, a session of 30 to 50 minutes of Pain Training in groups of 4 to 5 people will be given to the patients included in the Pain Training group at the beginning of the exercise training and the exercise training will begin.
Investigators
Ayşe Yaşar
physiotherapist
Medipol University
Eligibility Criteria
Inclusion Criteria
- •18 to 65 years old
- •Chronic low back pain 3 days a week and ≥ 3 months
- •Absence of spinal fracture or acute disc herniation
- •Absence of existing psychiatric problems and mental deficiencies
- •Absence of exercise contraindications \[28\] \[29\] \[30\]
Exclusion Criteria
- •Being diagnosed with lumbar radiculopathy
- •Pain due to tumors or infections, metastases, osteoporosis, inflammatory arthritis or fractures
- •Specific medical conditions (neck or back surgery in the previous 3 years, osteoporotic vertebral fractures or rheumatological diseases)
- •Chronic widespread pain syndromes (fibromyalgia or chronic fatigue syndrome)
- •Receiving any other treatment for chronic low back pain during the study \[28\] \[29\] \[30\]
Outcomes
Primary Outcomes
Change from baseline in the multidimensional measure of pain on the Short-Form McGill Pain Questionnaire at 3 weeks
Time Frame: baseline and 3 weeks
A multidimensional measure of pain. It consists of 2 subscales: 1) a sensory subscale consisting of 11 words or items, and 2) an emotional subscale consisting of 4 items rated on the intensity scale (0= none, 1= mild, 2= moderate, and 3= severe). It also includes 1 item for current pain intensity and 1 item for 10 cm Visual Analog Scale for mean pain.
Change from baseline in assessing feelings, thoughts, and emotions related to pain and disaster on the Pain Catastrophizing Scale at 3 weeks
Time Frame: baseline and 3 weeks
It is used to assess the patient's feelings, thoughts, and feelings about pain and disaster. It is a self-administered questionnaire with 13 items and 3 subscales: helplessness, magnification, and rumination. A 5-point scale is used for each item, with higher values representing greater destruction. The scores of each item are added to determine the subscales and the total score is calculated with the sum of all items. Scores range from 0 to 52 points.
Change from baseline of pain intensity on the Numerical Rating Scale at 3 weeks
Time Frame: baseline and 3 weeks
It is an 11-point unidimensional measure of pain intensity. It is a segmented numerical version of the Visual Analog Scale (VAS), in which participants select an integer (0-10 integer) that best reflects the intensity of their pain. 0 represents no pain and 10 represents worst pain.
Change from baseline in measuring fear of movement and (re)injury on the Tampa Kinesiophobia Scale at 3 weeks
Time Frame: baseline and 3 weeks
A 17-item questionnaire that measures fear of movement and (re)injury. Each question is answered on a 4-point Likert scale ranging from "strongly disagree" to "strongly agree". The total score is calculated after reversing the individual scores of items 4, 8, 12, and 16.
Change from baseline in questioning pain-related disability from low back pain on the Roland Morris Disability Questionnaire at 3 weeks
Time Frame: baseline and 3 weeks
A 24-item self-reported outcome measure questioning pain-related disability from low back pain. Items are scored 0 if left blank or 1 if approved. The total score ranges from 0 to 24; higher scores represent higher pain-related disability.
Identifying subjective neuropathic pain experience on the Pain Perception Questionnaire at baseline
Time Frame: baseline
It is a symptom-based assessment tool performed by clinicians to specify the subjective neuropathic pain experience of patients.
Change from baseline in the patient's ability to perform a range of activities despite pain in the Pain Self-Efficacy Questionnaire at 3 weeks
Time Frame: baseline and 3 weeks
A 10-item questionnaire that measures both the strength and generality of a patient's beliefs about their ability to perform a range of activities despite pain. Scores can range from 0 to 60, with higher scores indicating stronger self-efficacy beliefs.
Change from baseline in assessing internal factors and emotions influencing the experience of health-threatening physical injury and pain in the Pain Beliefs Questionnaire at 3 weeks
Time Frame: baseline and 3 weeks
The consists of two subscales. The organic beliefs subscale (PBQ-O) questions the user about physical injury or physiological pain that threaten wellness, while the psychological pain beliefs subscale (PBQ-P) evaluates intrinsic factors and emotions affecting the pain experience that may potentially threaten wellness.
Change from baseline in assessing overall quality of Sleep at 3 weeks
Time Frame: baseline and 3 weeks
It's about the overall quality of sleep about most nights in the last 7 days. It is scored between 1 and 10. High scores represent good sleep quality.
Measuring pain intensity and disability in the Revised Graded Chronic Pain Scale at baseline
Time Frame: baseline
The new scale, consisting of 6 questions, was developed as a revised version of the original scale. There is a categorical rating scheme and numerical self-assessment scores for pain intensity and disability. The first 2 questions ask the frequency of pain, how the pain affects life and work activities and evaluate the last 3 months. It is scored from 0 to 4 (0 = never to 4 = every day). Questions between 3 and 5 (PEG scale) evaluate the severity of pain in the last 7 days and are scored between 0-10 points. The third question questions the severity of the pain. Questions 4 and 5, respectively, ask how pain interferes with enjoying life and how it affects general activities. Question 6 has 2 answers (1=yes and 2=no) and asks if the person is not working or unable to work because of pain or painful condition.
Secondary Outcomes
- Change from baseline in maintaining a neutral lumbar spine in the Physical Performance Test Battery at 3 weeks(baseline and 3 weeks)
- Change from baseline on trunk mobility on the Finger-Place Test at 3 weeks(baseline and 3 weeks)
- Change from baseline in detecting structural lumbar segmental instability on Passive Lumbar Extension Test at 3 weeks(baseline and 3 weeks)