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Effects of pain neuroscience education on kinesiophobia in patients with chronic pain: a systematic review and meta-analysis

Physical Therapy Rehabilitation Science 2020년 9권 4호 p.309 ~ 317
김현중, 이승원,
소속 상세정보
김현중 ( Kim Hyun-Joong ) - Better Hospital Sports Rehabilitation Center
이승원 ( Lee Seung-Won ) - Sahmyook University College of Health Science and Social Welfare Department of Physical Therapy

Abstract


Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain.

Design: A systematic review and meta-analysis.

Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, ‘Cochrane’s risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis.

Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (?0.86; 95% confidence interval [CI], ?1.22 to ?0.51; heterogeneity [χ2=21.18, df=7, I2=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (?0.53; 95% CI, ?1.05 to ?0.01; heterogeneity [χ2=47.42, df=7, I2=85%]; overall effect [Z=2.01]).

Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.

키워드

Chronic pain; Education; Musculoskeletal pain; Neurosciences

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