12 The divergent results of the mentioned publications might result from looking at PNE effects for CLBP compared to heterogeneous chronic musculoskeletal pain. 12 They concluded that their results provide support for the addition of PNE to routine physiotherapy practice in CLBP. 11 The systematic review and meta-analysis by Wood and Hendrick derived that additional PNE to usual physiotherapy interventions in patients with CLBP does improve disability and pain in the short but not long term. 10 Another meta-analysis looking at PNE for chronic low back pain (CLBP) found moderate evidence that PNE shows small to moderate effects on pain and low-level evidence of a small to moderate effect on disability in the short term and also that PNE shows small to moderate effects on pain and disability at three month follow up.
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For kinesiophobia (short term) and catastrophizing (medium term) clinically relevant results could be shown. The results established low clinical relevance of PNE for pain and disability in short and medium term.
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In a recent meta-analysis looking at the effects of PNE for chronic musculoskeletal pain thirteen randomized controlled trials were considered. 7 If delivered in a combination with further interventions embracing a biopsychosocial framework PNE shows potential to reduce pain and disability. 8, 9 If patients adapt a contemporary pain understanding and integrate this new understanding in their life and rehabilitation process, they are more likely to allow adaptive coping strategies and behaviors, are less fearful and have better function in daily life. 8 The fundamental message is that pain is a marker of the perceived need to protect bodily tissue and not a marker of damage or disease. 7, 8 PNE is an educational intervention aiming to change patients' understanding of what pain is, what function it serves and what biological processes are proven to underpin it. Over the last two decades, a therapeutic approach named pain neuroscience education (PNE) has evolved. Kaiser et al 2 call for standardization of therapeutic procedures within IMPT to allow for reproducibility and research, thus it seems meaningful to develop a structured pain education content and explore its therapeutic efficacy.
#Program explain pain butler moseley pdf to word how to
As there are no detailed descriptions of how to apply pain education content during IMPT it is left at the discretion of the treatment center or institution. Education about pain and its underlying mechanisms also needs to be addressed 1 and patients' pain knowledge should be challenged during IMPT in concordance with contemporary pain neuroscience. 1, 3, 6 Patients should receive education about their prognosis, diagnosis and treatment options. While an interdisciplinary team delivers a variety of interventions, educating the patients is a strong common denominator through all professions and a consistent recommendation from clinical practice guidelines. 3 Even though IMPT is recommended and first-line treatment for chronic pain patients it is underutilized 4, 5 and actual content lacks transparency. 1, 2 Their published IMPT contents are recommended as best practice in the national guideline for the treatment of non-specific low back pain.
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1 Despite the lack of a clear international consensus on the definition for IMPT content, for the German health care system the structure and process parameters are defined and proposed by a task force of the German IASP (International Association for the Study of Pain) chapter. Interdisciplinary multimodal pain therapy (IMPT) is a recommended and complex intervention for people with persisting pain.