A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-term outcomes of pain and disability.

IF 1.6 4区医学 Q2 REHABILITATION

Physiotherapy Theory and Practice Pub Date : 2024-09-01 Epub Date: 2023-07-03 DOI:10.1080/09593985.2023.2232003

Xiaopeng Ma, Ruohan Chen, Wei Li, Peng Huang

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引用次数: 0

Abstract

Background: The evidence supporting the application of pain neuroscience education (PNE) in patients with chronic low back pain (LBP) remains some arguments.

Objective: This review aims to investigate the effect of PNE alone and combined with physical therapy or exercise for chronic LBP.

Methods: PubMed, Embase, Web of Science, and the Cochrane databases were searched from establishment to June 3, 2023. Randomized controlled trials (RCT) evaluating the effect of PNE in patients with chronic LBP were considered eligible. Data were analyzed using a random-effects model (I² >50%) or a fixed-effects model (I² <50%) and trials were appraised using the Cochrane ROB tool. Meta-regression was conducted to assess the moderator factors.

Results: Seventeen studies (1078 participants) were included in this review. PNE plus exercise and PNE plus physiotherapy both showed a reduction of short-term pain (mean differences [MD] -1.14 [-1.55, -0.72]; MD -1.15 [-1.67, -0.64]) and disability (standardized mean difference [SMD] -0.80 [-1.13, -0.47]; SMD -0.85 [-1.29, -0.40]) than physiotherapy or exercise alone. Meta-regression showed that only single PNE session duration was associated with a greater reduction in pain (P < .05). Subgroup results showed that a single PNE session exceeding 60 minutes (MD -2.04), 4 to 8 sessions (MD -1.34), intervention for 7 to 12 weeks (MD -1.32), and a group-based approach (MD -1.76) may be more beneficial.

Conclusion: This review indicates that adding PNE to treatment programs would lead to more efficacious effects for chronic LBP. Additionally, we preliminarily extracted dose-effect relationships for PNE intervention, providing guidance for clinicians to design effective PNE sessions.

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疼痛神经科学教育治疗慢性腰背痛的系统回顾和荟萃分析：疼痛和残疾的短期疗效。

背景：支持疼痛神经科学教育（PNE）在慢性腰背痛（LBP）患者中应用的证据仍存在一些争议：本综述旨在研究疼痛神经科学教育单独或与物理治疗或运动相结合治疗慢性腰背痛的效果：方法：检索了 PubMed、Embase、Web of Science 和 Cochrane 数据库，检索时间从建立到 2023 年 6 月 3 日。符合条件的研究对象均为评估PNE对慢性椎管内疼痛患者疗效的随机对照试验（RCT）。数据采用随机效应模型（I2>50%）或固定效应模型（I2 结果）进行分析：本综述共纳入 17 项研究（1078 名参与者）。与单纯物理治疗或锻炼相比，PNE 加锻炼和 PNE 加物理治疗均能减少短期疼痛（平均差 [MD] -1.14 [-1.55, -0.72]；MD -1.15 [-1.67, -0.64]）和残疾（标准化平均差 [SMD] -0.80 [-1.13, -0.47]；SMD -0.85 [-1.29, -0.40]）。元回归结果表明，只有单次持续时间与疼痛减轻程度相关（P 结论：在物理疗法和运动疗法中加入经颅神经阻滞疗法，能有效减轻疼痛：本综述表明，在治疗方案中加入 PNE 可为慢性腰椎间盘突出症带来更有效的治疗效果。此外，我们初步提取了PNE干预的剂量效应关系，为临床医生设计有效的PNE疗程提供了指导。

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来源期刊

Physiotherapy Theory and Practice REHABILITATION-

CiteScore

3.40

自引率

10.00%

发文量

300

期刊介绍： The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.