Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis

被引：267

作者：

Watson, James A. ^{[1
]}

Ryan, Cormac G. ^{[1
]}

Cooper, Lesley ^{[1
]}

Ellington, Dominic ^{[2
]}

Whittle, Robbie ^{[2
]}

Lavender, Michael ^{[2
]}

Dixon, John ^{[1
]}

Atkinson, Greg ^{[1
]}

Cooper, Kay ^{[3
]}

Martin, Denis J. ^{[1
]}

机构：

[1] Teesside Univ, Sch Hlth & Social Care, Middlesbrough TS1 3BX, Tees Valley, England

[2] Univ Hosp North Tees, North Tees & Hartlepool NHS Fdn Trust, Hardwick Rd, Stockton On Tees TS19 8PE, Cleveland, England

[3] Robert Gordon Univ, Scottish Ctr Evidenced Based Multiprofess Practic, Sch Hlth Sci, Joanna Briggs Inst Ctr Excellence, Aberdeen AB10 7QG, Scotland

来源：

JOURNAL OF PAIN | 2019年 / 20卷 / 10期

关键词：

Pain; neuroscience; education; chronic; systematic review;

D O I：

10.1016/j.jpain.2019.02.011

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualize an individual's understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate the clinical effectiveness, and patients' experience of, PNE for people with CMP. Electronic databases were searched for studies published between January 1, 2002, and June 14, 2018. Twelve randomized, controlled trials (n = 755 participants) that reported pain, disability, and psychosocial outcomes and 4 qualitative studies (n = 50 participants) that explored patients experience of PNE were included. The meta-analyzed pooled treatment effects for PNE versus control had low clinical relevance in the short term for pain (-5.91/100; 95% confidence interval [CI], -13.75 to 1.93) and disability (-4.09/100; 95% CI, -7.72 to -.45) and in the medium term for pain (-6.27/100; 95% CI, -18.97 to 6.44) and disability (-8.14/100; 95% CI, -15.60 to -.68). The treatment effect of PNE for kinesiophobia was clinically relevant in the short term (-13.55/100; 95% CI, -25.89 to -1.21) and for pain catastrophizing in the medium term (-5.26/52; 95% CI, -10.59 to .08). A metasynthesis of 23 qualitative findings resulted in the identification of 2 synthesized findings that identified several key components important for enhancing the patient experience of PNE, such as allowing the patient to tell their own story. These components can enhance pain reconceptualization, which seems to be an important process to facilitate patients' ability to cope with their condition. The protocol was published on PROSPERO (CRD42017068436). Perspective: We outline the effectiveness of PNE for the management of pain, disability, and psycho social outcomes in adults with CMP. Key components that can enhance the patient experience of PNE, such as allowing the patient to tell their own story, are also presented. These components may enhance pain reconceptualization. (C) 2019 by the American Pain Society

引用

页码：1140 / 1140

页数：1

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