Chronic Low Back Pain Clinical Trial
Official title:
The Effects of Culturally Sensitive Pain Education Program in Turkish Patients With Chronic Low Back Pain: A Pilot Randomized Controlled Trial
In last decade, the awareness has grown regarding the pain neuroscience education (PNE). In
the literature, it has been found that there is strong evidence that the educational strategy
of pain neuroscience education (PNE) can have positive effects on pain, disability,
catastrophization, and physical performance in chronic musculoskeletal disorders. Nowadays,
many physiotherapists integrate the PNE into the treatment of chronic pain. However, the
importance of culturally sensitive approaches for the treatment of chronic pain has been
proposed depending on the cultural differences of pain beliefs, pain cognitions, pain
experiences and pain coping strategies in different ethnic populations. Therefore, the aim of
this study is to compare the effects of a culturally sensitive PNE with a standard translated
PNE on pain intensity, disability status, pain pressure thresholds and psychosocial factors
(conceptualization of pain, pain beliefs, catastrophizing, kinesiophobia and illness
perception) in Turkish patients with chronic low back pain (LBP).
The effects of culturally sensitive PNE format will be compared with the standard translated
PNE in a pilot trial. 40 Turkish patients (first generation migrant living around Ghent) with
chronic LBP, between the age of 18 and 65 years, will be randomized to the culturally
sensitive PNE or standard translated PNE. The content of 2 sessions PNE include the
explanation about differences of acute and chronic pain, purpose of acute pain, production of
acute pain and chronic pain, and potential sustaining factors for central sensitization, but
presented in different ways. They will be subjected to an individual education session and
they will receive a home education program. In session 2 (after 1 week), they will come back
to ascertain that everything is understood.
In last decade, the awareness has grown regarding the pain neuroscience education (PNE). In
the literature, it has been found that there is strong evidence that the educational strategy
of pain neuroscience education (PNE) can have positive effects on pain, disability,
catastrophization, and physical performance in chronic musculoskeletal disorders. Nowadays,
many physiotherapists integrate the PNE into the treatment of chronic pain. However, the
importance of culturally sensitive approaches for the treatment of chronic pain has been
proposed depending on the cultural differences of pain beliefs, pain cognitions, pain
experiences and pain coping strategies in different ethnic populations. Therefore, the aim of
this study is to compare the effects of a culturally sensitive PNE with a standard translated
PNE on pain intensity, disability status, pain pressure thresholds and psychosocial factors
(conceptualization of pain, pain beliefs, catastrophizing, kinesiophobia and illness
perception) in Turkish patients with chronic low back pain (LBP).
The effects of culturally sensitive PNE format will be compared with the standard translated
PNE in a pilot trial. 40 Turkish patients (first generation migrant living around Ghent) with
chronic LBP, between the age of 18 and 65 years, will be randomized to the culturally
sensitive PNE or standard translated PNE. The content of 2 sessions PNE include the
explanation about differences of acute and chronic pain, purpose of acute pain, production of
acute pain and chronic pain, and potential sustaining factors for central sensitization, but
presented in different ways. They will be subjected to an individual education session and
they will receive a home education program. In session 2 (after 1 week), they will come back
to ascertain that everything is understood.
The primary outcomes include pain intensity and disability status. Secondary outcome measures
are pain pressure thresholds and psychosocial factors such as conceptualization of pain, pain
Beliefs, catastrophizing, kinesiophobia and illness perceptions. Pain thresholds will be
assessed with the pressure algometer. Pressure will be applied bilaterally at 3 pressure
points: one on the mass of erector spinae muscle, one on the quadriceps muscle, and one on
the trapezius muscle. All outcomes will be evaluated at baseline, day 7 (immediately after
session 2) and after 1 month follow-up.
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