International Spine Pain Institute, Story City, IA, USA.
Arch Phys Med Rehabil. 2011 Dec;92(12):2041-56. doi: 10.1016/j.apmr.2011.07.198.
To evaluate the evidence for the effectiveness of neuroscience education (NE) for pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain.
Systematic searches were conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search.
All experimental studies including randomized controlled trials (RCTs), nonrandomized clinical trials, and case series evaluating the effect of NE on pain, disability, anxiety, and stress for chronic MSK pain were considered for inclusion. Additional limitations: studies published in English, published within the last 10 years, and patients older than 18 years. No limitations were set on specific outcome measures of pain, disability, anxiety, and stress.
Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach.
Methodological quality was assessed by 2 reviewers using the Critical Review Form-Quantitative Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT, and 1 comparative study involving 401 subjects. Most articles were of good quality, with no studies rated as poor or fair. Heterogeneity across the studies with respect to participants, interventions evaluated, and outcome measures used prevented meta-analyses. Narrative synthesis of results, based on effect size, established compelling evidence that NE may be effective in reducing pain ratings, increasing function, addressing catastrophization, and improving movement in chronic MSK pain.
For chronic MSK pain disorders, there is compelling evidence that an educational strategy addressing neurophysiology and neurobiology of pain can have a positive effect on pain, disability, catastrophization, and physical performance.
评估神经科学教育（NE）在慢性肌肉骨骼（MSK）疼痛中的疼痛、残疾、焦虑和压力方面的有效性证据。
在 Biomed Central、BMJ.com、CINAHL、Cochrane 图书馆、NLM 中央网关、OVID、ProQuest（数字论文）、PsycInfo、PubMed/Medline、ScienceDirect 和 Web of Science 上进行了系统搜索。进行了二次搜索（PEARLing），即审查选定文章的参考文献列表，以查找主要搜索中未识别的其他参考文献。
所有实验研究，包括随机对照试验（RCT）、非随机临床试验和病例系列，均评估了 NE 对慢性 MSK 疼痛的疼痛、残疾、焦虑和压力的影响，均被认为符合纳入标准。其他限制：发表在英语的研究、在过去 10 年内发表的研究以及年龄大于 18 岁的患者。对疼痛、残疾、焦虑和压力的特定结果测量没有限制。
使用参与者、干预措施、比较和结果（PICO）方法提取数据。
两名审查员使用批判性评价表格-定量研究评估方法学质量。本综述包括 8 项研究，涉及 6 项高质量 RCT、1 项伪 RCT 和 1 项涉及 401 名受试者的比较研究。大多数文章质量较高，没有文章评为差或一般。由于研究对象、评估的干预措施和使用的结果测量指标存在异质性，因此无法进行荟萃分析。基于效应量的结果叙述性综合表明，NE 可能在减轻疼痛评分、提高功能、解决灾难化和改善慢性 MSK 疼痛中的运动方面具有显著效果。
对于慢性 MSK 疼痛障碍，有确凿的证据表明，针对疼痛的神经生理学和神经生物学的教育策略可能对疼痛、残疾、灾难化和身体表现产生积极影响。
