Pain neuroscience education for patients with chronic pain: A scoping review from teaching–learning strategies, educational level, and cultural perspective

Salazar-Méndez, Joaquín; Cuyul-Vásquez, Iván; Ponce-Fuentes, Felipe; Guzmán-Muñoz, Eduardo; Núñez-Cortés, Rodrigo; Huysmans, Eva; Lluch-Girbés, Enrique; Viscay-Sanhueza, Nelson; Fuentes, Jorge

doi:10.1016/j.pec.2024.108201

Cited by 3 publications

(2 citation statements)

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“…PNE has shown positive results on the kinesiophobia, catastrophizing, pain intensity, disability, and physical performance in patients with CLBP ( Moseley, Nicholas & Hodges, 2004 ; Ryan et al, 2010 ; Louw et al, 2011 ; Malfliet et al, 2017 ; Rufa, Beissner & Dolphin, 2018 ; Núñez Cortés et al, 2023a ; Nuñez Cortés et al, 2023b ). A recent meta-analysis has shown that the in-group PNE had better results than individual PNE for kinesiophobia ( Romm et al, 2021 ), and it has been identified, in other types of health education, that there are greater benefits in those people who received the in-group intervention ( Riemsma, Taal & Rasker, 2003 ), probably supported by the fact that educational sessions conducted in-group modality can facilitate learning through social observation of positive behaviors exhibited by other members within the group ( Romm et al, 2021 ; Salazar-Méndez et al, 2024 ). However, there are no primary studies comparing the two PNE modalities directly.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, despite increasing evidence that SDH are influential factors in clinical health outcomes to a greater extent than the quality and availability of medical care ( Daniel, Bornstein & Kane, 2018 ), there are no studies that analyze specifically the influence of SDH factors ( e.g. , educational level) on the effectiveness of PNE ( Salazar-Méndez et al, 2024 ).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of in-group versus individually administered pain neuroscience education on clinical and psychosocial outcomes in patients with chronic low back pain: randomized controlled study protocol

Salazar-Méndez,

Cuyul-Vásquez,

Ponce-Fuentes

et al. 2024

PeerJ

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Objective (1) This trial will compare the clinical and psychosocial effectiveness of in-group and individually pain neuroscience education (PNE) in patients with chronic low back pain (CLBP). In addition, (2) the influence of social determinants of health on post-treatment results will be analyzed. Methods A three-arm randomized controlled trial will be conducted. Sixty-nine participants with CLBP will be recruited in a 1:1:1 ratio. Participants, assessor, and statistician will be blinded to group assignment. The PNE intervention will be adapted to the context of the participants. An experimental group (n = 33) will receive PNE in an in-group modality, the other experimental group (n = 33) will receive PNE in an individually modality and the control group (n = 33) will continue with usual care. Additionally, participants will be encouraged to stay active by walking for 20–30 min 3–5 times per week and will be taught an exercise to improve transversus abdominis activation (bracing or abdominal following). The outcome measures will be fear avoidance and beliefs, pressure pain threshold, pain self-efficacy, catastrophizing, pain intensity, and treatment expectation. Outcome measures will be collected at one-week before intervention, immediately post-intervention, and four-weeks post-intervention. Conclusion The innovative approach of PNE oriented to fear beliefs proposed in this study could broaden the application strategies of this educational therapeutic modality. Impact. Contextualized PNE delivered by physical therapist could be essential to achieve a good cost-effectiveness ratio of this intervention to improve the clinical condition of people with CLBP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of in-group versus individually administered pain neuroscience education on clinical and psychosocial outcomes in patients with chronic low back pain: randomized controlled study protocol

Salazar-Méndez,

Cuyul-Vásquez,

Ponce-Fuentes

et al. 2024

PeerJ

Self Cite

View full text Add to dashboard Cite

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Effects of pain neuroscience education combined with neuromuscular exercises on pain, functional disability and psychological factors in chronic low back pain: A study protocol for a single-blind randomized controlled trial

Alvani,

Sheikhi,

Letafatkar

et al. 2024

PLoS ONE

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Objective Chronic low back pain (CLBP) is a prevalent health condition worldwide. Several therapeutic interventions aim to improve CLBP. Pain Neuroscience Education (PNE) helps patients better understand their pain from biological and physiological perspectives, which clinicians use to reduce pain and disability in patients with chronic musculoskeletal conditions. Neuromuscular exercises (NMS) are also treatments adopted in CLBP. This study will investigate whether PNE combined with an NMS program improves pain, functional and psychological outcomes more than NMS alone in patients with CLBP. Methods In this single-blind randomized controlled trial, 60 patients (male and female; age range, 30–60 years) diagnosed with CLBP will be randomly assigned to one of the following groups: (1) PNE plus NMS (n = 30; 24 sessions of PNE plus NMS in a total of 8 weeks, 3 each week), and (2) NMS alone (n = 30; 24 sessions of NMS sessions in a total of 8 weeks, 3 each week). Outcome assessors will be blinded to the group allocation. The primary outcome will be pain. Secondary outcomes will be disability, fear-avoidance beliefs about work and physical activity, self-efficacy, exercise anxiety, and kinesiophobia. Outcomes will be assessed at baseline, after 8 weeks of intervention, and 6 months post-intervention. Discussion The findings of this RCT will help shed light on new treatment strategies to address the biopsychosocial dimensions of CLBP. The study protocol will be conducted in a clinical setting, offering the opportunity for future implementation in healthcare systems. Moreover, it will help clarify whether a combined treatment (PNE with NMS) is more effective than NMS alone for improving pain, functional and psychological outcomes in CLBP. Trial registration Study registration: The study was prospectively registered in the Iranian Registry of Clinical Trials—IRCT20190427043384N2 (https://www.irct.ir/trial/69146). Registered on March 17, 2023.

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Comparing AI-Generated and Clinician-Created Personalized Self-Management Guidance for Knee Osteoarthritis Patients: A Blinded Observational Study (Preprint)

Du,

Li,

Zuo

et al. 2024

Preprint

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BACKGROUND Background: Personalized education is crucial for effective knee osteoarthritis (OA) management, but providing it remains challenging due to imbalanced patient-provider ratio and limited resources. This study explores the potential of GPT-4, a large language model, in generating tailored self-management guidance and compares its performance with physician-provided advice. OBJECTIVE Objective：This study aims to evaluate the effectiveness of GPT-4 in generating personalized education materials for patients with knee osteoarthritis (OA) and compare it with experienced clinicians. Specifically, the comparison is made in terms of efficiency, readability, accuracy, personalization, comprehensiveness, and safety. By leveraging patient data from previous trials, it is evaluated whether AI can improve the quality and accuracy of patient education and evaluate its potential in improving patient care and outcomes. METHODS Methods: A two-phase, blinded, observational study was conducted using patient data from a previous trial. In phase one, two experienced orthopedic specialists created personalized education materials. In phase two, the same data were input into GPT-4 by a physician to generate content. Materials were evaluated for efficiency (words per minute), readability (Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, and SMOG Index), accuracy, personality, comprehensiveness, and safety. RESULTS Results: GPT-4 demonstrated higher efficiency than clinicians (median 530.03 vs. 37.29 WPM, P < 0.001). GPT-4 content exhibited superior readability on the Flesch-Kincaid grade level, Gunning Fog Index, and SMOG Index (P < 0.001). Expert evaluations revealed that GPT-4 outperformed clinicians in accuracy (5.307 ± 1.731 vs. 4.76 ± 1.098, P = 0.047), personality (54.32 ± 6.212 vs. 33.2 ± 5.395, P < 0.001), comprehensiveness (51.74 ± 6.471 vs. 35.26 ± 6.657, P < 0.001), and safety (median 61 vs. 50, P < 0.001). CONCLUSIONS Conclusion: GPT-4 shows promise in generating high-quality, personalized patient education for knee OA, surpassing human experts. This study provides novel evidence for the potential of AI in enabling precise and intelligent patient education. Further research is needed to validate the findings in larger populations and assess the impact on patient outcomes.

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Pain neuroscience education for patients with chronic pain: A scoping review from teaching–learning strategies, educational level, and cultural perspective

Cited by 3 publications

References 108 publications

Effectiveness of in-group versus individually administered pain neuroscience education on clinical and psychosocial outcomes in patients with chronic low back pain: randomized controlled study protocol

Effectiveness of in-group versus individually administered pain neuroscience education on clinical and psychosocial outcomes in patients with chronic low back pain: randomized controlled study protocol

Effects of pain neuroscience education combined with neuromuscular exercises on pain, functional disability and psychological factors in chronic low back pain: A study protocol for a single-blind randomized controlled trial

Comparing AI-Generated and Clinician-Created Personalized Self-Management Guidance for Knee Osteoarthritis Patients: A Blinded Observational Study (Preprint)

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