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A Randomized Controlled Trial of Intensive Neurophysiology Education in Chronic Low Back Pain
Abstract
OBJECTIVES: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. METHODS: This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal "drawing-in" task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. RESULTS: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. DISCUSSION: Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.
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“The only current model, of energetic and personalized explanation of pain, 10 still lacks application in mainstream pain management”
From Patient action as means and end of chronic pain care: Risks and routes to meaningful action (2017) · cites this paper as [10]
In the citing paper
“A previous study looking at the efficacy of brief education intervention found that neurophysiology education led to some normalization of attitudes and beliefs about pain, a reduction in catastrophizing, and improvement in physical performance [20].”
In the citing paper
“This form of pain education (widely known as ‘Explain Pain’ or ‘Pain Neuroscience Education’)15–24 was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.15 17 21 23–25”
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BackgroundLouw, A., Zimney, K. J., Puentedura, E. J., & Diener, I. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194646 · Cited by 738
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BackgroundMethodInfluentialLouw, A., Diener, I., Butler, D. S., & Puentedura, E. J. (2011) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2011.07.198 · Cited by 686
Delitto, A., George, S. Z., Dillen, L. V., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2012.42.4.a1 · Cited by 1,219
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“The study was a RCT designed to evaluate the efficacy of the CB-CFT according to the system proposed by O’Sullivan (2005), as compared with MT-EX in patients with NSCLBP.”
ResultInfluentialTargeting Cortical Representations in the Treatment of Chronic Pain
Moseley, G. L., & Flor, H. (2012) · Neurorehabilitation and neural repair · doi:10.1177/1545968311433209 · Cited by 482
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Nijs, J., Paul van Wilgen, C., Van Oosterwijck, J., van Ittersum, M., & Meeus, M. (2011) · Manual Therapy · doi:10.1016/j.math.2011.04.005 · Cited by 390
“In patients with chronic low back pain, pain physiology education alters pain perceptions and, in conjunction with physiotherapy, it improves functional and symptomatic outcomes (Moseley, 2002; Moseley, 2003b; Moseley et al., 2004; Moseley, 2005).”
BackgroundReconceptualising pain according to modern pain science
Moseley, G. L. (2007) · Physical Therapy Reviews · doi:10.1179/108331907x223010 · Cited by 334
Self-citationIndividual patient education for low back pain
Engers, A. J., Jellema, P., Wensing, M., van der Windt, D., Grol, R. P. T. M., & van Tulder, M. W. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004057.pub3 · Cited by 317
A Mechanism-Based Approach to Physical Therapist Management of Pain
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“There are no good published models of this practice yet, although there is evidence that effective education can mobilise patients to start to rehabilitate [39].”
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How Good Is the Neurophysiology of Pain Questionnaire? A Rasch Analysis of Psychometric Properties
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Self-citationTreatment of central sensitization in patients with chronic pain: time for change?
Nijs, J., Leysen, L., Vanlauwe, J., Logghe, T., Ickmans, K., Polli, A., Malfliet, A., Coppieters, I., & Huysmans, E. (2019) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2019.1647166 · Cited by 239
Wijma, A. J., van Wilgen, C. P., Meeus, M., & Nijs, J. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194651 · Cited by 243
“…education (PNE) (Gallagher, McAuley, and Moseley, 2013; Louw, Diener, Butler, and Puentedura, 2011; Meeus et al, 2010; Moseley, 2002; Moseley, 2004; Moseley and Butler, 2013; Moseley, Nicholas, and Hodges, 2004; Nijs et al, 2011a; Van Oosterwijck et al, 2011; Van Oosterwijck et al, 2013).”
Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories
Nijs, J., Girbés, E. L., Lundberg, M., Malfliet, A., & Sterling, M. M. (2014) · Manual Therapy · doi:10.1016/j.math.2014.07.004 · Cited by 204
“There is some evidence that pain neuroscience education (Moseley, 2004; Moseley et al., 2004; van Oosterwijck et al., 2011) may be an effective sole treatment for people with chronic musculoskeletal pain.”
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Pelletier, R., Higgins, J., & Bourbonnais, D. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0480-y · Cited by 215
“Educational programs explaining the neurophysiological mechanisms of pain have proven more effective than back schools (which emphasize end organ dysfunction and behavioural changes to decrease loading of anatomical structures) in CLBP patients [49-51,197].”
BackgroundPreoperative Pain Neuroscience Education for Lumbar Radiculopathy
Louw, A., Diener, I., Landers, M. R., & Puentedura, E. J. (2014) · Spine · doi:10.1097/brs.0000000000000444 · Cited by 207
Smart, K. M., Blake, C. M., Staines, A. S., Thacker, M. A., & Doody, C. (2012) · Manual Therapy · doi:10.1016/j.math.2012.03.013 · Cited by 204
“For example, there is some evidence to suggest that educating patients about the neurobiology of pain as a therapeutic intervention might improve illness beliefs, movement performance and lessen the threat value of pain (Moseley, 2002; Moseley et al., 2004; Van Oosterwijck et al., 2011).”
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Moseley, G. L. (2003) · Journal of Manual & Manipulative Therapy · doi:10.1179/106698103790826383 · Cited by 178
Self-citationGallagher, L. B., McAuley, J. H., & Moseley, G. L. (2012) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182465cf7 · Cited by 178
“We might instead predict that metaphor and story may be best utilized at the initial point of contact to loosen existing concepts, making them more amenable to change, and to pave the way for other more explicit interventions that are known to reduce pain levels and disability in people with chronic pain: for example…”
BackgroundSelf-citationOosterwijck, J. V., Nijs, J., Meeus, M., Truijen, S., Craps, J., den Keybus, N. V., & Paul, L. (2011) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2009.12.0206 · Cited by 177
“Education about the neurophysiology of pain has been studied in chronic pain populations, such as chronic low back pain [27,29–32] and chronic fatigue syndrome [33].”
BackgroundCentral sensitization, chronic pain, and other symptoms: Better understanding, better management
Volcheck, M. M., Graham, S. M., Fleming, K. C., Mohabbat, A. B., & Luedtke, C. A. (2023) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.90a.22019 · Cited by 204
Ryan, C. G., Gray, H., Newton, M., & Granat, M. H. (2010) · Manual Therapy · doi:10.1016/j.math.2010.03.003 · Cited by 174
“This form of intervention can decrease pain, pain related fear and behaviour, and increase self-reported function when provided alone or in conjunction with usual care physiotherapy (Moseley, 2002, 2004, 2005; Moseley et al., 2004).”
BackgroundInfluentialA prospective sequential analysis of the fear-avoidance model of pain
Wideman, T. H., Adams, H., & Sullivan, M. J. L. (2009) · Pain · doi:10.1016/j.pain.2009.04.022 · Cited by 171
“Additionally, alternate interventions such as education and exposure have been shown to lower the levels of catastrophizing [16,23,24].”
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“This finding is reminiscent of the reported worsening in pain beliefs observed in LBP patients after receiving information about anatomy and biomechanics of the spine [34].”
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Neurophysiological Pain Education for Patients With Chronic Low Back Pain
Tegner, H., Frederiksen, P., Esbensen, B. A., & Juhl, C. B. (2018) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000594 · Cited by 154
“The difference in favor of NPE in reduction in Tampa Scale of Kinesiophobia was not statistically significant, WMD=−5.73 (95% CI, −13.60 to 2.14) and after 3 months WMD=−0.94 (95% CI, −6.28 to 4.40).”
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“We included 12 studies with 3,583 patients reported in 13 papers [6,22,50,52,54‐64], eight were of high quality (Table 2a, Table 2b) [6, 50 ,52,57,60,61,64].”
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“Pain neurophysiology education aims at reconceptualising pain, and was found to be effective in reducing pain catastrophising in those with chronic low back pain (Moseley et al., 2004) and chronic widespread pain (Meeus et al.”
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Self-citationGeneen, L. J., Martin, D. J., Adams, N., Clarke, C., Dunbar, M., Jones, D., McNamee, P., Schofield, P., & Smith, B. H. (2015) · Systematic Reviews · doi:10.1186/s13643-015-0120-5 · Cited by 129
“Nine studies were included (Ferrell et al. 1997 [17], Gallagher et al. 2013 [18]; Linton et al. 1997 [11], Morrison et al. 1988 [12], Moseley et al. 2004 [19], PAIN INTENSITY Education versus usual care “average pain” Soares 2002; Ruehlman 2013 18 17 35 SMD random 0 0.02 [−0.19, 0.24] 0.21 0.83…”
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“Remote technologies also have the potential to deliver pain physiology education, which are effective in alleviating pain catastrophizing [34; 36].”
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“…pain (Louw, Louw, and Crous, 2009) and recent studies in non-surgical orthopedic patients with chronic low back pain (LBP) (Moseley, 2002, 2004; Moseley, Hodges, and Nicholas, 2004) and whiplash associated disorders (Van Oosterwijck et al, 2011) have shown that patients are able to understand…”
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“PNE, by its definition, is an educational intervention aiming to alter a patient’s beliefs and cognitions regarding their pain experience [13,20,22].”
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“” Notable exceptions include studies in which the educational intervention is based on the biopsychosocial model rather than a biomedical model [35, 40–42], which was the case in this RCT.”
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“Previous research suggests that a wide range of interventions can lead to reductions in pain catastrophizing [20,21,29,33].”
Paatelma, M., Kilpikoski, S., Simonen, R. L., Heinonen, A. O., Alén, M., & Videman, T. (2008) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0262 · Cited by 102
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“…PNE in patients with chronic pain in terms of reduced pain, pain catastrophization, disability, and improved physical performance (Clarke, Ryan, and Martin, 2011; Louw, Diener, Butler, and Puentedura, 2011; Moseley, 2002; Moseley, 2003a; Moseley, 2003b; Moseley, Nicholas, and Hodges, 2004).”
BackgroundCoakley, R., & Wihak, T. (2017) · Children · doi:10.3390/children4020009 · Cited by 100
Malfliet, A., Kregel, J., Meeus, M., Roussel, N., Danneels, L., Cagnie, B., Dolphens, M., & Nijs, J. (2018) · Physical Therapy · doi:10.1093/ptj/pzx092 · Cited by 100
Wälti, P., Kool, J., & Luomajoki, H. A. (2015) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-015-0533-2 · Cited by 101
“Various research groups have demonstrated the potential value of focusing on abnormal cortical processing of the central nervous system (CNS) in patients with nonspecific chronic low back pain (NSCLBP) [7-14]: abnormal cortical processing includes cognitive, sensory and motor disturbances.”
Nijs, J., Wijma, A. J., Willaert, W., Huysmans, E., Mintken, P., Smeets, R., Goossens, M., van Wilgen, C. P., Van Bogaert, W., Louw, A., et al. (2020) · Physical Therapy · doi:10.1093/ptj/pzaa021 · Cited by 97
Placebo analgesia: Clinical applications
Klinger, R., Colloca, L., Bingel, U., & Flor, H. (2013) · Pain · doi:10.1016/j.pain.2013.12.007 · Cited by 99
“Such an educational informative approach ought to explain the placebo effect based on the models of classical conditioning and expectancy, but also its neurobiological bases, without overstraining the patient [31] (eg, the therapist can inform about pharmacological and psychological effects of analgesics, emphasize le…”
BackgroundBruce, R. D., Merlin, J. S., Lum, P. J., Ahmed, E., Alexander, C. S., Corbett, A., Foley, K. M., Leonard, K., Treisman, G. J., & Selwyn, P. A. (2017) · Clinical Infectious Diseases · doi:10.1093/cid/cix636 · Cited by 94
“However, the sample size was small and the patients were not identified as having HIV [81].”
BackgroundThe Sensitization Model to Explain How Chronic Pain Exists Without Tissue Damage
van Wilgen, C. P., & Keizer, D. (2010) · Pain Management Nursing · doi:10.1016/j.pmn.2010.03.001 · Cited by 91
Lee, H., McAuley, J. H., Hübscher, M., Kamper, S. J., Traeger, A. C., & Moseley, G. L. (2016) · Pain · doi:10.1097/j.pain.0000000000000472 · Cited by 90
“The following constructs were identified as potential confounders of the indirect, direct, and total effects: pain duration (months), diagnosis, patients’ expectation of outcome (11-point numeric rating scale), and patients’ perception of the clinician (empathy, attentiveness, and expertise–each rated on an 11-point n…”
BackgroundMethodSelf-citationMoseley, G. L., Leake, H. B., Beetsma, A. J., Watson, J. A., Butler, D. S., van der Mee, A., Stinson, J., Harvie, D. S., Palermo, T. M., Meeus, M., et al. (2023) · Journal of Pain · doi:10.1016/j.jpain.2023.11.008 · Cited by 99
Self-citationHøvik, L. H., Winther, S. B., Foss, O. A., & Gjeilo, K. H. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-1073-0 · Cited by 86
“Psychological and psychosocial interventions [49], education and instruction in self-management skills [50] or exercise and physical therapy [51, 52] were shown to be effective in reducing pain catastrophizing to some degree.”
BackgroundThe Current State of Physical Therapy Pain Curricula in the United States: A Faculty Survey
Bement, M. H., & Sluka, K. A. (2014) · Journal of Pain · doi:10.1016/j.jpain.2014.11.001 · Cited by 82
“Further, there is a strong body of literature supporting the use of exercise for almost all pain conditions(23) and a growing body of literature showing the effectiveness of education of the patient on the science of pain, providing support for the incorporation of these concepts in PT pain curricula.(19,24,26,34) Fur…”
BackgroundWritten pain neuroscience education in fibromyalgia: a multicenter randomized controlled trial
van Ittersum, M. W., van Wilgen, C. P., van der Schans, C. P., Lambrecht, L., Groothoff, J. W., & Nijs, J. (2014) · Pain Practice · doi:10.1111/papr.12137 · Cited by 79
A neuroscience approach to managing athletes with low back pain
Puentedura, E. J., & Louw, A. (2011) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2011.12.001 · Cited by 79
Hybrid Approach to Treatment Tailoring for Low Back Pain: A Proposed Model of Care
Hodges, P. W. (2019) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2019.8774 · Cited by 82
Self-citationBeneciuk, J. M., & George, S. Z. (2015) · Physical Therapy · doi:10.2522/ptj.20140418 · Cited by 77
Giummarra, M. J., Casey, S. L., Devlin, A. L., Ioannou, L., Gibson, S. J., Georgiou‐Karistianis, N., Jennings, P., Cameron, P. A., & Ponsford, J. (2017) · PAIN Reports · doi:10.1097/pr9.0000000000000622 · Cited by 75
Rehabilitation of chronic whiplash: treatment of cervical dysfunctions or chronic pain syndrome?
Nijs, J., Oosterwijck, J. V., & Hertogh, W. D. (2009) · Clinical Rheumatology · doi:10.1007/s10067-008-1083-x · Cited by 73
“Pain physiology education was found to be effective in reducing pain catastrophizing in those with chronic low back pain [63, 64].”
BackgroundListening is therapy: Patient interviewing from a pain science perspective
Diener, I., (6366965), M. K., & Louw, A. (2016) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2016.1194648 · Cited by 82
“…associated with the utilization of TNE have focused on a variety of disorders including: chronic low back pain (Moseley, 2002; Moseley, 2004; Moseley, Nicholas, and Hodges, 2004); lumbar surgery (Louw, Diener, Landers, and Puentedura, 2014; Puentedura et al, 2009); whiplash associated…”
Javdaneh, N., Saeterbakken, A. H., Shams, A., & Barati, A. H. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18168848 · Cited by 71
“One of the essential aims of pain neuroscience education intervention is to alter patients’ beliefs and cognitions regarding their pain experience [50].”
BackgroundPhysical and psychological aspects of whiplash: Important considerations for primary care assessment
Sterling, M. M., & Kenardy, J. A. (2008) · Manual Therapy · doi:10.1016/j.math.2007.11.003 · Cited by 70
“Cognitive approaches including education in various forms have been shown to be effective in reducing pain and disability in whiplash (Oliveira et al., 2006) as well as influencing pain cognitions in low back pain (Moseley et al., 2004).”
BackgroundSørensen, P. H., Bendix, T., Manniche, C., Korsholm, L., Lemvigh, D., & Indahl, A. (2010) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-11-212 · Cited by 73
“Cognitive theories include elements of central pain perception as well as optimisation of peripheral muscular control[14-23].”
BackgroundRobinson, V., King, R., Ryan, C. G., & Martin, D. J. (2016) · Manual Therapy · doi:10.1016/j.math.2015.10.001 · Cited by 69
A systematic review of cross‐cultural validation of the pain catastrophizing scale
Ikemoto, T., Hayashi, K., Shiro, Y., Arai, Y.-C. P., Marcuzzi, A., Costa, D. S. J., & Wrigley, P. J. (2020) · European Journal of Pain · doi:10.1002/ejp.1587 · Cited by 73
King, R., Robinson, V., Elliott-Button, H. L., Watson, J. A., Ryan, C. G., & Martin, D. (2018) · Pain Research and Management · doi:10.1155/2018/3745651 · Cited by 69
Daluiso-King, G., & Hebron, C. (2020) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2020.1765440 · Cited by 68
“…bio-psycho-social factors can be found to positively impact upon health outcomes, drawing healthcare further away from the BMM (Lumley et al., 2011; Moseley, Nicholas, and Hodges, 2004) toward the alternative BPSM, where the values of humanism2 and scientism3 are proposedly intertwined (Brosschot,…”
BackgroundFletcher, C., Bradnam, L. V., & Barr, C. (2016) · Physiotherapy Theory and Practice · doi:10.3109/09593985.2015.1138010 · Cited by 72
“However, Moseley, Nicholas, and Hodges (2004) reported that specific PNE training in people with chronic pain yielded a mean rNPQ score of around 60% and our mean of the rNPQ score was 55% (range 23–84%).”
BackgroundMethodResultInfluentialSaraçoğlu, İ., Arık, M. I., Afşar, E., & Gökpınar, H. H. (2020) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2020.1809046 · Cited by 70
“Several studies evaluating the efficacy of PNE in CLBP showed that PNE combined with MT and exercise had favorable statistical effects on levels of pain and disability (Moseley, 2002; Moseley, Nicholas, and Hodges, 2004; Nijs et al., 2014).”
BackgroundLouw, A., Butler, D. S., Diener, I., & Puentedura, E. J. (2013) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0b013e3182876aa4 · Cited by 63
“nervous system and the brain’s processing of pain and nociceptive input.(34,43) This approach is in direct”
BackgroundMethodInfluentialBement, M. H., Marie, B. S., Nordstrom, T. M., Christensen, N., Mongoven, J. M., Koebner, I. J., Fishman, S. M., & Sluka, K. A. (2013) · Physical Therapy · doi:10.2522/ptj.20130346 · Cited by 63
Immediate Effects of Mirror Therapy in Patients With Shoulder Pain and Decreased Range of Motion
Louw, A., Puentedura, E. J., Reese, D., Parker, P., Miller, T., & Mintken, P. E. (2017) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2017.03.031 · Cited by 63
Amer-Cuenca, J. J., Pecos‐Martín, D., Martínez‐Merinero, P., Girbés, E. L., Nijs, J., Meeus, M., Peña, R. F., & Fernández‐Carnero, J. (2019) · Pain Medicine · doi:10.1093/pm/pnz069 · Cited by 65
Barbari, V., Storari, L., Ciuro, A., & Testa, M. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.11.031 · Cited by 73
Herr, K., Marie, B. S., Gordon, D. B., Paice, J. A., Watt‐Watson, J., Stevens, B., Bakerjian, D., & Young, H. M. (2015) · Journal of Nursing Education · doi:10.3928/01484834-20150515-02 · Cited by 62
Sharma, S., Jensen, M. P., Moseley, G. L., & Abbott, J. H. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026874 · Cited by 61
Self-citationLouw, A., Diener, I., Landers, M. R., Zimney, K., & Puentedura, E. J. (2016) · Journal of Spine Surgery · doi:10.21037/jss.2016.12.04 · Cited by 59
“Various randomized controlled trials (RCT) and a systematic review have shown that PNE has a positive effect on pain, disability, pain catastrophization, and physical movement for patients with chronic low back pain (CLBP), extending to 1-year outcomes (22-26).”
BackgroundCoakley, R., Wihak, T., Kossowsky, J., Iversen, C., & Donado, C. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx112 · Cited by 59
Cox, T., Louw, A., & Puentedura, E. J. (2016) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2015.1122308 · Cited by 62
Dillen, L. R. V., Norton, B. J., Sahrmann, S. A., Evanoff, B., Harris‐Hayes, M., Holtzman, G. W., Earley, J. A., Chou, I., & Strube, M. (2016) · Manual Therapy · doi:10.1016/j.math.2016.04.003 · Cited by 62
“The 3 components of the NCs prescription were derived from the literature (Hansen et al., 1993; Friedrich et al., 1996, 1998; Mannion et al., 1999; Moffett et al., 1999; Taimela et al., 2000; Moseley et al., 2004).”
MethodBülow, K., Lindberg, K., Vægter, H. B., & Juhl, C. B. (2020) · Pain Medicine · doi:10.1093/pm/pnaa484 · Cited by 61
Reflecting on new models for osteopathy – it's time for change
Smith, D. (2019) · International journal of osteopathic medicine · doi:10.1016/j.ijosm.2018.10.001 · Cited by 58
Sham Surgery in Orthopedics: A Systematic Review of the Literature
Louw, A., Diener, I., Fernández‐de‐las‐Peñas, C., & Puentedura, E. J. (2016) · Pain Medicine · doi:10.1093/pm/pnw164 · Cited by 57
Metadata
- Authors
- Moseley, G. L., Nicholas, M. K., & Hodges, P. W.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Moseley, G. Lorimer
- Hodges, Paul W.
- Venue
- The Clinical Journal of Pain
- Published
- 2004
- Volume
- 20
- Issue
- 5
- Pages
- 324-330
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2078673653
- Cited by
- 537
- References
- 50
- Citations by year
- 2026: 16 · 2025: 23 · 2024: 36 · 2023: 32 · 2022: 24 · 2021: 50 · 2020: 45 · 2019: 31 · 2018: 34 · 2017: 31 · 2016: 40 · 2015: 34 · 2014: 18 · 2013: 20 · 2012: 16
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- neurophysiology education, chronic low back pain, pain-related cognitions, pain catastrophizing, pain attitudes, disability, physical performance, cognitive-behavioral pain management, physiotherapy education
- MeSH terms
- Adult, Analysis of Variance, Chronic Disease, Double-Blind Method, Female, Humans, Male, Middle Aged, Neurophysiology, Pain Measurement, Patient Education as Topic, Psychomotor Performance, Surveys and Questionnaires, Cognitive Behavioral Therapy, Low Back Pain
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