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Randomized Controlled Trial
. 2020 Jul;20(6):600-614.
doi: 10.1111/papr.12884. Epub 2020 Apr 20.

Does Pain Neuroscience Education and Cognition-Targeted Motor Control Training Improve Cervical Motor Output? Secondary Analysis of a Randomized Clinical Trial

Ward Willaert  1   2   3 , Anneleen Malfliet  1   2   3   4   5 , Iris Coppieters  1   2   3   4 , Dorine Lenoir  1   2   3 , Robby De Pauw  2 , Lieven Danneels  2 , Nathalie Roussel  6 , Mira Meeus  2   3   6 , Barbara Cagnie  2 , Jo Nijs  1   3   4 , Jeroen Kregel  1   2   3
Affiliations
Randomized Controlled Trial

Does Pain Neuroscience Education and Cognition-Targeted Motor Control Training Improve Cervical Motor Output? Secondary Analysis of a Randomized Clinical Trial

Ward Willaert et al. Pain Pract. 2020 Jul.

Abstract

Background: In the context of interventions aimed at reducing pain, disability, and maladaptive pain cognitions in chronic neck pain, it is hypothesized that patients who have greater symptom reduction possibly also demonstrate greater improvement in cervical motor output. Therefore, the aim of this study was to examine the effect of pain neuroscience education plus cognition-targeted motor control training on cervical motor output.

Methods: Impairments in cervical motor output were measured in 64 subjects with chronic neck pain using standardized tests. Cervical muscle strength, cervical mobility, balance, and cervical neuromuscular control were derived. To assess the differences between groups in response to treatment, a random-intercept linear mixed-models analysis, applying a diagonal covariance matrix, was used.

Results: A significant treatment × time interaction effect was found for neuromuscular control of the deep cervical flexors, favoring the experimental treatment at 3 months' follow-up (mean group difference: 1.982; 95% confidence interval 0.779, 3.185; large effect size d = 0.82). Significant main effects of time were found for the neuromuscular capacity of scapulothoracic muscles and for cervical mobility. No significant effects were found for balance, cervical muscle strength, or endurance of cervical flexors.

Conclusion: Pain neuroscience education combined with cognition-targeted motor control training is not more effective than biomedically focused education and exercise therapy for improving cervical motor output in people with chronic neck pain. Our findings question the relative importance of factors such as pain, disability, and maladaptive pain cognitions on cervical motor output and the need to address it in treatment.

Trial registration: ClinicalTrials.gov NCT02098005.

Keywords: exercise therapy; head movements; motor activity; neck pain; neuroscience education.

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References

    1. Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006;15:834-848.
    1. Seroussi R, Singh V, Fry A. Chronic whiplash pain. Phys Med Rehabil Clin North Am. 2015;26:359-373.
    1. Treleaven J. Dizziness, unsteadiness, visual disturbances, and sensorimotor control in traumatic neck pain. J Orthop Sports Phys Ther. 2017;47:492-502.
    1. Treleaven J, Takasaki H. Characteristics of visual disturbances reported by subjects with neck pain. Man Ther. 2014;19:203-207.
    1. Nijs J, Meeus M, Cagnie B, et al. A modern neuroscience approach to chronic spinal pain: combining pain neuroscience education with cognition-targeted motor control training. Phys Ther. 2014;94:730-738.

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