Effects of Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students

NCT ID: NCT07005778

Last Updated: 2025-06-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-12

Study Completion Date

2025-03-12

Brief Summary

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The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. The main questions this study aims to answer are:

Does a single-session PNE-based education improve students' beliefs about the relationship between pain and disability? Does it reduce reliance on biomedical (organic) pain beliefs compared to traditional pain education? In this study, researchers will compare PNE-based education to traditional pain education, both delivered through 70-minute lectures.

Participants were randomly assigned to either the PNE group or the traditional education group, attended a one time 70-minute classroom lecture, completed questionnaires at three time points: before the session, immediately after, and 3 months later.

The main tools used will be the Health Care Providers' Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Pain Beliefs Questionnaire (PBQ), which includes organic and psychological subscales.

This study aims to support the integration of contemporary pain neuroscience content into physiotherapy assistant curricula to enhance biopsychosocial understanding at an early stage of professional education.

Detailed Description

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In Turkey, research on the impact of pain neuroscience education (PNE) on the knowledge, beliefs, and attitudes of undergraduate physiotherapy students remains scarce. Moreover, there appears to be no study that directly contrasts traditional pain education with a PNE-based approach that conceptualizes pain as an outcome-driven process, enriched with metaphors and storytelling. Existing literature suggests that physiotherapy assistant programs often provide limited exposure to neuroscience content, which may contribute to the lack of significant improvements in students' understanding and attitudes toward pain following PNE.

Against this background, the current study was developed to explore how a metaphor-supported, case-based PNE intervention influences the pain-related knowledge and beliefs of physiotherapy assistant students. To the best of our knowledge, no prior study in Turkey has systematically evaluated the effects of PNE within this specific student group. Therefore, a randomized controlled trial was designed to compare the outcomes of traditional structural pain education and a neuroscience-based educational program on pain-related beliefs and attitudes among physiotherapy assistant students.

Conditions

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Musculoskeletal Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Traditional Pain Education

Participants in the control group received a 70-minute lecture based on the biomedical model of pain.

Group Type ACTIVE_COMPARATOR

Traditional pain education

Intervention Type OTHER

Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury.

PNE based education

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain.

Group Type EXPERIMENTAL

PNE-based education

Intervention Type OTHER

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors.

Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience.

Interventions

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Traditional pain education

Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury.

Intervention Type OTHER

PNE-based education

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors.

Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Students were eligible to participate if they were undergraduate physiotherapy assistant students enrolled at the Vocational School of Health Services.

Exclusion Criteria

* Individuals were excluded if they had previously received in-depth teaching on pain neurophysiology or traditional pain education.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Pamukkale University

OTHER

Sponsor Role collaborator

Akdeniz University

OTHER

Sponsor Role lead

Responsible Party

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Hatice Gül

Head of Therapy and Rehabilitation Department of Vocational School of Health Services

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hatice Gül

Role: PRINCIPAL_INVESTIGATOR

Akdeniz University

Locations

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Akdeniz University

Antalya, Konyaaltı, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Mankelow J, Ryan C, Taylor P, Martin D. The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial. Musculoskelet Sci Pract. 2020 Dec;50:102249. doi: 10.1016/j.msksp.2020.102249. Epub 2020 Aug 28.

Reference Type RESULT
PMID: 32920228 (View on PubMed)

Cox T, Louw A, Puentedura EJ. An abbreviated therapeutic neuroscience education session improves pain knowledge in first-year physical therapy students but does not change attitudes or beliefs. J Man Manip Ther. 2017 Feb;25(1):11-21. doi: 10.1080/10669817.2015.1122308. Epub 2016 Feb 10.

Reference Type RESULT
PMID: 28855788 (View on PubMed)

Colleary G, O'Sullivan K, Griffin D, Ryan CG, Martin DJ. Effect of pain neurophysiology education on physiotherapy students' understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial. Physiotherapy. 2017 Dec;103(4):423-429. doi: 10.1016/j.physio.2017.01.006. Epub 2017 Mar 22.

Reference Type RESULT
PMID: 28797666 (View on PubMed)

Other Identifiers

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03.10.2024, TBAEK-683

Identifier Type: -

Identifier Source: org_study_id

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