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Does Pain Neuroscience Education and Cognition‐Targeted Motor Control Training Improve Cervical Motor Output? Secondary Analysis of a Randomized Clinical Trial
Author(s) -
Willaert Ward,
Malfliet Anneleen,
Coppieters Iris,
Lenoir Dorine,
De Pauw Robby,
Danneels Lieven,
Roussel Nathalie,
Meeus Mira,
Cagnie Barbara,
Nijs Jo,
Kregel Jeroen
Publication year - 2020
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12884
Subject(s) - medicine , neck pain , physical medicine and rehabilitation , balance (ability) , context (archaeology) , physical therapy , cognition , randomized controlled trial , cervical dystonia , anesthesia , botulinum toxin , psychiatry , alternative medicine , paleontology , pathology , biology
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.