Saracoglu Ismail, Arik Meltem Isintas, Afsar Emrah, Gokpinar Hasan Huseyin
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey.
Physiother Theory Pract. 2022 Jul;38(7):868-878. doi: 10.1080/09593985.2020.1809046. Epub 2020 Aug 19.
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). : 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. : Analysis of pain level ( < .05), back performance ( < .05), disability ( < .05) and kinesiophobia ( < .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. : 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).
本研究旨在探讨疼痛神经科学教育（PNE）联合手法治疗（MT）及家庭锻炼计划（HEP）对慢性下腰痛（CLBP）患者疼痛强度、背部功能、残疾程度和运动恐惧的短期及中期影响。本研究设计为一项前瞻性、随机、对照、单盲研究，将69名参与者随机分为三组。第一组参与者接受PNE、MT及HEP，第二组参与者接受MT及HEP。对照组参与者仅进行HEP。所有干预持续4周。对参与者的疼痛强度、残疾程度、下背部功能及运动恐惧进行评估。所有评估均由同一名盲法物理治疗师在干预前、干预后4周及12周进行。对每个结局指标采用重复测量混合模型。疼痛程度（<.05）、背部功能（<.05）、残疾程度（<.05）和运动恐惧（<.05）的分析显示出显著的时间、组间及时间与组间的交互效应。与第二组和对照组参与者相比，第一组参与者在疼痛强度和运动恐惧方面有更大改善。与对照组相比，第一组和第二组的残疾程度均显著降低。本研究表明，联合PNE、MT及HEP的多模式治疗方案是在短期（4周）和中期（12周）改善背部功能、减轻疼痛、残疾程度和运动恐惧的有效方法。
