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ABSTRACT: Background
Spinal manipulative therapy (SMT) demonstrates small effects on pain intensity in low back pain. Combining SMT with a psychosocial intervention like pain neuroscience education (PNE) could promote additional effect.Objectives
To evaluate the additional effect of PNE when combined to SMT on pain intensity and low back pain-related disability in patients with chronic low back pain (CLBP).Method
One hundred and four patients with CLBP of both sexes aged between 18 and 55 years were treated with PNE + SMT compared to SMT alone. The primary outcome measures were pain intensity and disability post-treatment (4 weeks). Secondary outcomes were fear-avoidance beliefs, global perceived effect of improvement, and pain self-efficacy. Results were obtained immediately post-treatment and at three follow-ups (30-days, 90-days, and 180-days).Results
No significant between-group difference was observed for pain intensity and disability post-treatment. In contrast, our results showed a significantly longer additional effect for the group treated with SMT + PNE for the following outcomes: pain intensity (change baseline to 90 day follow-up = -0.90 [95% CI= -1.76, -0.4] and change baseline to 180 day follow-up = -1.19 [95% CI= -2.06, -0.32]) and low back pain-related disability, global perceived effect of improvement and pain self-efficacy (180th day follow-up).Conclusion
The results of this trial suggest the addition of PNE to SMT did not bring any additional effect on pain intensity and disability in the short term, but SMT + PNE can result in longer-lasting effects in patients with CLBP and that such an effect could be related to a possible mediator effect of pain self-efficacy.
SUBMITTER: Tavares FAG
PROVIDER: S-EPMC10598742 | biostudies-literature | 2023 Sep-Oct
REPOSITORIES: biostudies-literature
Tavares Fernando Augusto Gonçalves FAG Rossiter João Vitor Alves JVA Lima Gabriela Caroline Leandro GCL de Oliveira Letícia Gomes LG Cavalcante Witor Souza WS Ávila Mariana Arias MA George Steven Zachary SZ Chaves Thais Cristina TC
Brazilian journal of physical therapy 20230901 5
<h4>Background</h4>Spinal manipulative therapy (SMT) demonstrates small effects on pain intensity in low back pain. Combining SMT with a psychosocial intervention like pain neuroscience education (PNE) could promote additional effect.<h4>Objectives</h4>To evaluate the additional effect of PNE when combined to SMT on pain intensity and low back pain-related disability in patients with chronic low back pain (CLBP).<h4>Method</h4>One hundred and four patients with CLBP of both sexes aged between 18 ...[more]