Pain Neuroscience Education Combined With Lumbar Stabilization Exercises on Disability and Kinesiophobia Among Patients With Chronic Low Back Pain

NCT ID: NCT07307859

Last Updated: 2025-12-29

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-20

Study Completion Date

2026-09-01

Brief Summary

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This study will investigate the effect of adding Pain Neuroscience Education (PNE) to a standard lumbar stabilization exercise program on disability and kinesiophobia among patients with chronic low back pain in the Gaza Strip. Participants will be randomly assigned into two groups:

Control group - will receive lumbar stabilization exercises only.

Experimental group - will receive lumbar stabilization exercises in addition to PNE delivered once weekly for 8 sessions.

Both groups will undergo an 8-week intervention, and outcome measures will be collected at baseline, post-intervention (8 weeks), and at a follow-up assessment (16 weeks) to evaluate the persistence of treatment effects. It is expected that the experimental group will show greater improvements in disability and kinesiophobia compared with the control group, indicating that integrating PNE with stabilization exercises may provide enhanced and sustained benefits for patients with chronic low back pain.

Detailed Description

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This study will explore whether integrating Pain Neuroscience Education (PNE) with a lumbar stabilization exercise program can produce superior clinical outcomes for individuals with chronic low back pain. The intervention will be delivered over eight weeks, with both groups participating in supervised lumbar stabilization sessions. The experimental group will additionally receive weekly PNE sessions designed to improve pain understanding, modify unhelpful beliefs, and reduce fear-avoidance behaviors.

PNE sessions will focus on explaining the neurophysiological mechanisms of chronic pain, emphasizing concepts such as central sensitization, the protective nature of pain, and the role of thoughts, emotions, and movement in pain modulation. The lumbar stabilization exercises will aim to improve trunk control, enhance spinal stability, and promote functional movement patterns.

Participants will be assessed at baseline, after completion of the intervention period, and again at a later follow-up to examine the sustainability of treatment effects. The study is expected to provide evidence on whether combining educational and physical interventions yields greater improvements in disability and kinesiophobia compared with stabilization exercises alone. This information may support future clinical decision-making and contribute to improving physiotherapy services for patients with chronic low back pain in the Gaza Strip.

Conditions

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Chronic Low Back Pain

Keywords

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pain neuroscience lumbar stabilization disability

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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Lumbar Stabilization Exercises

Standard Lumbar Stabilization Exercise Program A physiotherapy program focused solely on core and trunk stabilization exercises without additional educational components.

Group Type ACTIVE_COMPARATOR

Control Group - Lumbar Stabilization Exercises Only

Intervention Type OTHER

Lumbar Stabilization Exercises (LSE)

Frequency: 3 supervised sessions per week for 8 weeks

→ Total 24 supervised LSE sessions

Session duration: 45-60 minutes

Structure: Identical warm-up, core program, and cool-down as the experimental group.

Progression: Identical 8-week exercise progression.

Home program: 1 basic LSE home session weekly (same as experimental group).

Communication: Therapists will not provide pain education or discuss pain science concepts.

Adherence: Attendance logs and SMS reminders identical to the experimental group.

Lumbar Stabilization Exercises Plus Pain Neuroscience Education

Lumbar Stabilization Program Integrated with Weekly Pain Neuroscience Education Sessions A combined intervention including trunk stabilization exercises supported by once-weekly educational sessions addressing pain mechanisms and fear-avoidance beliefs.

Group Type EXPERIMENTAL

Experimental Group - Lumbar Stabilization Exercises + PNE

Intervention Type OTHER

Experimental Group - Lumbar Stabilization Exercises + PNE

1. Lumbar Stabilization Exercises (LSE)

Frequency: 3 supervised sessions per week for 8 weeks

→ Total 24 supervised LSE sessions

Session duration: 45-60 minutes

Structure each session:

Warm-up (5-10 min)

Core stabilization program (30-40 min)

Cool-down (5-10 min)

Progression: Exercises will advance weekly from basic motor control to high-level functional stabilization (details below).

Home program: 1 additional short home session weekly (basic LSE).

Monitoring: VAS before and after each session. Exercises will be modified if pain rises \>2 VAS points.

Adherence: Attendance logs
2. Pain Neuroscience Education (PNE)

Frequency: Once per week (included within one of the 3 weekly sessions)

→ Total 8 PNE sessions

Duration: 30-40 minutes

Format: Small group (≤5) or one-on-one

Methods: Metaphors, storytelling, diagrams, role-play, Arabic handouts

Learning evaluation: Mini-quizzes, reflective journaling, i

Interventions

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Experimental Group - Lumbar Stabilization Exercises + PNE

Experimental Group - Lumbar Stabilization Exercises + PNE

1. Lumbar Stabilization Exercises (LSE)

Frequency: 3 supervised sessions per week for 8 weeks

→ Total 24 supervised LSE sessions

Session duration: 45-60 minutes

Structure each session:

Warm-up (5-10 min)

Core stabilization program (30-40 min)

Cool-down (5-10 min)

Progression: Exercises will advance weekly from basic motor control to high-level functional stabilization (details below).

Home program: 1 additional short home session weekly (basic LSE).

Monitoring: VAS before and after each session. Exercises will be modified if pain rises \>2 VAS points.

Adherence: Attendance logs
2. Pain Neuroscience Education (PNE)

Frequency: Once per week (included within one of the 3 weekly sessions)

→ Total 8 PNE sessions

Duration: 30-40 minutes

Format: Small group (≤5) or one-on-one

Methods: Metaphors, storytelling, diagrams, role-play, Arabic handouts

Learning evaluation: Mini-quizzes, reflective journaling, i

Intervention Type OTHER

Control Group - Lumbar Stabilization Exercises Only

Lumbar Stabilization Exercises (LSE)

Frequency: 3 supervised sessions per week for 8 weeks

→ Total 24 supervised LSE sessions

Session duration: 45-60 minutes

Structure: Identical warm-up, core program, and cool-down as the experimental group.

Progression: Identical 8-week exercise progression.

Home program: 1 basic LSE home session weekly (same as experimental group).

Communication: Therapists will not provide pain education or discuss pain science concepts.

Adherence: Attendance logs and SMS reminders identical to the experimental group.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults aged 25to 50 years.
* CLBP lasting for more than 12 weeks.

Exclusion Criteria

* History of spinal surgery or fractures.
* Presence of neurological problems.
* Inflammatory conditions, including radiculopathy.
* Pregnancy.
* Body mass index (BMI) ≥ 30.
* Chronic systemic diseases or conditions requiring regular use of strong analgesics or opioids, which may interfere with intervention outcomes.
* Significant visual or hearing impairments.
Minimum Eligible Age

25 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Al-Azhar University

OTHER

Sponsor Role lead

Responsible Party

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Mosab ALdabbas

Assistant Professor at Al Azhar University ,Palestine, Gaza

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Mosab Aldabbas Last Name or Official Title: Aldabbas First Name: Mosab, PhD

Role: CONTACT

Phone: 00972597451222

Email: [email protected]

Other Identifiers

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Al Azhar University , Gaza

Identifier Type: -

Identifier Source: org_study_id