Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India.
Departmet of Physical Medicine & Rehabilitation, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India.
PLoS One. 2024 May 28;19(5):e0294302. doi: 10.1371/journal.pone.0294302. eCollection 2024.
BACKGROUND: Low back pain stands as a prevalent contributor to pain-related disability on a global scale. In addressing chronic low back pain (CLBP), there is a growing emphasis on incorporating psychological strategies into the management process. Among these, pain education interventions strive to reshape pain beliefs and mitigate the perceived threat of pain. This randomized controlled trial sought to assess the effects of pain education on various aspects, including pain levels, disability, quality of life, self-efficacy, and prognostic characteristics in individuals grappling with CLBP. METHODS: The clinical trial, retrospectively registered with the Clinical Trials Registry of India (CTRI/2021/08/035963), employed a two-arm parallel randomized design. Ninety-two participants with CLBP were randomly assigned to either the standard physiotherapy care with a pain education program or the control group. Both groups underwent a 6-week intervention. Assessment of pain intensity (using NPRS), disability (using RMDQ), self-efficacy (using the general self-efficacy scale), and well-being (using WHO 5I) occurred both before and after the 6-week study intervention. FINDINGS: Post-intervention score comparisons between the groups revealed that the pain education intervention led to a significant reduction in disability compared to the usual standard care at 6 weeks (mean difference 8.2, p < 0.001, effect size Cohen d = 0.75), a decrease in pain intensity (mean difference 3.5, p < 0.001, effect size Cohen d = 0.82), and an improvement in the well-being index (mean difference 13.7, p < 0.001, effect size Cohen d = 0.58). CONCLUSION: The findings suggest that integrating a pain education program enhances the therapeutic benefits of standard physiotherapy care for individuals dealing with chronic LBP. In conclusion, the clinical benefits of pain education become apparent when delivered in conjunction with standard care physiotherapy during the management of chronic low back pain.
背景:腰痛是全球范围内导致疼痛相关残疾的主要原因。在治疗慢性腰痛(CLBP)时,越来越强调将心理策略纳入管理过程。其中,疼痛教育干预旨在重塑疼痛观念,减轻对疼痛的感知威胁。这项随机对照试验旨在评估疼痛教育对疼痛程度、残疾、生活质量、自我效能和预后特征等方面的影响,以评估疼痛教育对患有慢性腰痛的个体的影响。
方法:这项临床试验在印度临床试验注册中心(CTRI/2021/08/035963)进行了回顾性注册,采用了两臂平行随机设计。92 名 CLBP 患者被随机分配到标准物理治疗加疼痛教育组或对照组。两组均接受 6 周的干预。在 6 周的研究干预前后,使用 NPRS 评估疼痛强度,使用 RMDQ 评估残疾程度,使用一般自我效能感量表评估自我效能,使用 WHO 5I 评估幸福感。
结果:组间干预后评分比较显示,与常规标准护理相比,疼痛教育干预在 6 周时显著降低了残疾程度(平均差异 8.2,p<0.001,Cohen d 效应大小=0.75),降低了疼痛强度(平均差异 3.5,p<0.001,Cohen d 效应大小=0.82),提高了幸福感指数(平均差异 13.7,p<0.001,Cohen d 效应大小=0.58)。
结论:研究结果表明,将疼痛教育方案纳入标准物理治疗可增强其对慢性 LBP 患者的治疗效果。综上所述,在慢性腰痛的管理中,疼痛教育与标准物理治疗相结合时,其临床获益更为明显。
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