School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.
Center for Health Technology and Services Research (CINTESIS), Piso 2, Edifício nascente, Porto, Portugal.
Phys Ther. 2022 Jun 3;102(6). doi: 10.1093/ptj/pzac048.
Pain neuroscience education (PNE) and exercise have emerged as potential interventions in adolescents with chronic pain; however, very few studies have explored their effectiveness. Blended-learning approaches combining face-to-face and online educational sessions have also emerged as facilitating methods of health education. This study aimed to compare the effectiveness of exercises and PNE versus exercise alone in adolescents with chronic neck pain (NP).
A randomized controlled trial with 6-month follow-up was conducted in 2 high schools. Over 8 weeks, a total of 127 adolescents with chronic NP were randomly allocated to either (1) perform functional and region-specific exercises, including generalized neuromuscular control, endurance, and strength exercises, as well as exercises targeting the deep neck flexor and extensor muscles and scapular stabilizer muscles; or (2) perform the same exercise-based intervention plus PNE. Pain intensity (primary outcome), disability, sleep, catastrophizing, fear of movement, self-efficacy, and knowledge of pain neuroscience were assessed at baseline, postintervention, and 6-month follow-up. Neck and scapular muscle endurance and pressure pain thresholds were assessed at baseline and postintervention. Patient's Global Impression of Change was assessed postintervention and at 6-month follow-up.
There was a significant decrease in pain intensity from baseline to postintervention and from baseline to follow-up in both groups, but there were no between-group differences or interactions between time and groups. These results were similar for the secondary outcomes, except for knowledge of pain neuroscience, for which a significant group and time interaction was found.
Exercise and exercise plus PNE were similarly effective in treating adolescents with chronic NP, and the results were maintained for up to 6 months. Further studies are needed to explore the effect of these interventions for longer follow-ups.
疼痛神经科学教育（PNE）和运动已成为治疗慢性疼痛青少年的潜在干预措施；然而，很少有研究探讨它们的有效性。结合面对面和在线教育课程的混合学习方法也已成为促进健康教育的方法。本研究旨在比较运动和 PNE 与单独运动对慢性颈痛（NP）青少年的疗效。
这是一项在 2 所高中进行的为期 6 个月随访的随机对照试验。在 8 周的时间里，共有 127 名患有慢性 NP 的青少年被随机分配到以下两组之一：（1）进行功能和特定区域的运动，包括广义的神经肌肉控制、耐力和力量运动，以及针对深层颈部屈肌和伸肌以及肩胛稳定肌的运动；或（2）进行相同的基于运动的干预加 PNE。在基线、干预后和 6 个月随访时评估疼痛强度（主要结局）、残疾、睡眠、灾难化、运动恐惧、自我效能和疼痛神经科学知识。在基线和干预后评估颈和肩胛肌肉耐力和压痛阈值。在干预后和 6 个月随访时评估患者对变化的总体印象。
两组患者的疼痛强度均从基线下降到干预后，从基线下降到随访，且组间无差异或时间与组间无交互作用。除了疼痛神经科学知识，这一结果在次要结局中也相似，因为发现了显著的组间和时间交互作用。
运动和运动加 PNE 对治疗慢性 NP 青少年同样有效，且结果在 6 个月内保持不变。需要进一步的研究来探讨这些干预措施在更长时间的随访中的效果。
