Shoulder Pain Clinical Trial
Official title:
Effectiveness of Pain Neuroscience Education vs Biomedical Education for Patients Undergoing Surgery for Shoulder Pain: Protocol for a Randomized Controlled Trial
BACKGROUND Shoulder pain is the third most common musculoskeletal disorder observed in
primary care consultations after low back and neck pain. In the absence of successful outcome
following a conservative intervention, shoulder surgery is the most common procedure conduct
for a multitude of surgical indications, including rotator cuff tears, instability and
stiffness. However, 22% of patients develop chronic shoulder pain (CSP) following shoulder
surgery . The consequences of chronic or persistent postsurgical pain result in high
socio-economic burden, not only in terms of suffering and reduced quality of life for the
individual, but also, with considered the subsequent costs to healthcare and social services.
Pain neuroscience education (PNE) has been shown as an effective therapeutic strategy for
increasing knowledge and understanding about neurobiology, neurophysiology and processing
pain, changing pain beliefs, improving patient's skills and encouraging to do physical and
social activities in different chronic pain conditions.
The primary aim of this study will be to evaluate whether perioperative PNE is more effective
than classical biomedical education in reducing pain and disability in patients undergoing
shoulder surgery. The secondary aim will be to analyse whether perioperative PNE is more
effective than classical biomedical education in reducing postoperative healthcare costs and
improving surgical experience in patients undergoing shoulder surgery .
The present study will be a 6-month randomized controlled trial that will be carried out
between March 2017 and Aug 2017 in a regional hospital (secondary care setting ) of the
province of Malaga, Spain. Participants scheduled for shoulder surgery and those that fulfil
inclusion criteria will be asked for participating in this study. The outcomes will be
assessed at baseline (in the week preceding surgery) and at 3 follow-ups times (1 week, 1
month and 6 months' post-surgery t1-t4 ).
All patients scheduled for shoulder surgery in the participating hospital and meeting the age
criteria will be contacted by telephone and interviewed after having given consent. The
initial telephone interview serves to provide a verbal description of the project and to
screen potential study participants for in- and exclusion criteria (see above). People deemed
likely to be eligible and willing to participate in the study will be scheduled for baseline
assessments in the week before surgery. Furthermore, they will receive written information
about the study via mail or e-mail. Prior to undertaking the baseline assessments, they will
have the opportunity to ask questions and will be asked to provide written informed consent.
Anonymized age, gender and visual analogue scale- verbal numerical rating scale (VAS-VNRS)
for pain will be collected for those participants who decline to take part in the project, to
assess the external validity of the recruited sample of participants.
Participants are not expected to start new treatments or medication other than their usual
pre- and postoperative care 3 weeks prior to and during study participation. Participants
will then complete several questionnaires at baseline, 1 week, 1 month and 6 months'
post-intervention apart from biomedical education or PNE intervention. Retention of
participants will be encouraged by researchers providing written feedback to all participants
about the results of the "health screenings", maintaining the interest in the study through
materials and mailings sent to participants during all the process and using reminders of the
upcoming data collection. Participant data files will be stored in numerical order and in a
secure and accessible place and manner. Participant files will be maintained in storage for a
period of 3 years after completion of the study.
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