Comparing Pain Neuroscience Education Followed by Motor Control Exercises With Group‐Based Exercises for Chronic Low Back Pain: A Randomized Controlled Trial
Pouya Rabiei, Bahram Sheikhi, Amir Letafatkar
Abstract
Abstract Background Different individualized interventions have been used to improve chronic low back pain (CLBP). However, their superiority over group‐based interventions has yet to be elucidated. We compared an individualized treatment involving pain neuroscience education (PNE) plus motor control exercise (MCE) with group‐based exercise (GE) in patients with CLBP. Methods Seventy‐three patients with CLBP were randomly assigned into the PNE plus MCE group ( n = 37) and GE group ( n = 36). Both PNE plus MCE and GE were administered twice weekly for 8 weeks. Pain intensity (as measured using the VAS), disability (as measured using the Roland‐Morris Disability Questionnaire), fear‐avoidance beliefs (as measured using the Fear‐Avoidance Beliefs Questionnaire), and self‐efficacy (as measured using the Pain Self‐Efficacy Questionnaire) were assessed at baseline and 8 weeks post‐intervention. A 2 × 2 variance analysis (treatment group × time) with a mixed‐model design was applied to statistically analyze the data. Results Both groups showed significant improvements in all the outcome measures, with a large effect size ( P < 0.001, partial eta squared [ηp 2 ] = 0.66 to 0.81) after the intervention. The PNE plus MCE group showed greater improvements, with a moderate effect size in pain intensity ( P = 0.041, ηp 2 = 0.06) and disability ( P = 0.021, ηp 2 = 0.07) compared to the GE group. No significant difference was found in fear‐avoidance beliefs during physical activity and work, and self‐efficacy ( P > 0.05) between the 2 groups. Conclusion PNE and MCE seem to be better at reducing pain intensity and disability compared to GE, while no significant differences were observed for fear‐avoidance beliefs and self‐efficacy between the 2 groups in patients with CLBP. With regard to the superiority of individualized interventions over group‐based ones, more studies are warranted.