Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of medical sciences, Shiraz, Iran.
PLoS One. 2022 Jun 16;17(6):e0269785. doi: 10.1371/journal.pone.0269785. eCollection 2022.
Previous studies into Low Back Pain (LBP) assessed the effects of physical interventions or face-to-face (FTF) education mostly in western cultures. The present study aimed to compare the effects of multimedia and FTF pain management education (PME) on pain intensity and pain catastrophizing among participants with chronic LBP.
This double-blind randomized controlled clinical trial was conducted on ninety participants with chronic LBP randomly allocated to either multimedia, FTF, or control groups. Participants in the multimedia group received PME through watching seven educational CDs at home and their counterparts in the FTF group received the same educations in seven weekly FTF educational sessions. Pain intensity (using a numerical rating scale) and pain catastrophizing (using the Pain Catastrophizing Scale) were assessed before, immediately after, and one month after the study intervention. The effects of the interventions were assessed using the repeated-measures multivariate analysis of variance (MANOVA). Effect size and minimal detectable change (MDC) were reported for both variables. The regression model used in the present study was Generalized Estimating Equations (GEE).
The findings of MANOVA showed the significant effects of time on pain intensity and pain catastrophizing (P<0.001). The Tukey's test showed that before and immediately after the intervention, the mean scores of pain intensity and pain catastrophizing in the FTF and PME groups were significantly different from the control group (P<0.001 and P = 0.001, respectively). MDC did not show clinically significant changes in the mean score of pain intensity and GEE revealed significant difference among the groups.
The findings suggested that multimedia PME is as effective as FTF education in reducing pain intensity and pain catastrophizing among participants with LBP. Future studies into the effects of education on LBP are recommended to consider longitudinal designs, a reliable cutoff score for pain catastrophizing, and participants' physical ability.
IRCT20180313039074N1.
先前的腰痛（LBP）研究评估了物理干预或面对面（FTF）教育对西方文化中参与者的影响。本研究旨在比较多媒体和 FTF 疼痛管理教育（PME）对慢性 LBP 参与者疼痛强度和疼痛灾难化的影响。
这是一项双盲随机对照临床试验，共纳入 90 名慢性 LBP 患者，随机分为多媒体组、FTF 组和对照组。多媒体组患者在家观看 7 张教育 CD 接受 PME，FTF 组患者每周接受 7 次 FTF 教育课程。在研究干预之前、之后立即和一个月后评估疼痛强度（使用数字评分量表）和疼痛灾难化（使用疼痛灾难化量表）。使用重复测量多元方差分析（MANOVA）评估干预的效果。报告了两个变量的效应大小和最小可检测变化（MDC）。本研究中使用的回归模型是广义估计方程（GEE）。
MANOVA 的结果表明，时间对疼痛强度和疼痛灾难化有显著影响（P<0.001）。Tukey 检验显示，在干预前和干预后立即，FTF 和 PME 组的疼痛强度和疼痛灾难化的平均得分与对照组有显著差异（P<0.001 和 P = 0.001）。MDC 没有显示疼痛强度平均得分的临床显著变化，GEE 显示组间有显著差异。
研究结果表明，多媒体 PME 与 FTF 教育一样有效，可以减轻 LBP 患者的疼痛强度和疼痛灾难化。建议对教育对 LBP 的影响进行进一步研究，考虑采用纵向设计、疼痛灾难化的可靠截断分数和参与者的身体能力。
IRCT 注册号：IRCT20180313039074N1。
