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The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: a single-blind randomized controlled trial
Saracoglu I, Arik MI, Afsar E, Gokpinar HH
Physiotherapy Theory and Practice 2022;38(7):868-878
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The aim of this study was to investigate the short- and mid-term effects of pain neuroscience education (PNE) combined with manual therapy (MT) and a home exercise program (HEP) on pain intensity, back performance, disability, and kinesiophobia in patients with chronic low back pain (CLBP). METHODS: This study was designed as a prospective, randomized, controlled, single-blind study in which 69 participants were randomly assigned to three groups. Participants in group 1 received PNE, MT, and the HEP, while group 2 received MT and the HEP. Participants in the control group did the HEP only. All interventions lasted 4 weeks. The participants' pain intensity, disability, low back performance, and kinesiophobia were assessed. All assessments were executed before intervention, at 4 weeks, and at 12 weeks post-intervention by the same blinded physiotherapist. A mixed model for repeated measures was used for each outcome measure. RESULTS: Analysis of pain level (p < 0.05), back performance (p < 0.05), disability (p < 0.05) and kinesiophobia (p < 0.05) revealed significant time, group, and time-by-group interaction effects. The participants in group 1 exhibited greater improvement in terms of pain intensity and kinesiophobia compared to the participants in group 2 and the control group. Level of disability was significantly decreased in both group 1 and group 2 compared to the control group. CONCLUSION: This study suggests that a multimodal treatment program combining PNE, MT, and HEP is an effective method for improving back performance and reducing pain, disability, and kinesiophobia in the short (4 weeks) and midterm (12 weeks).

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