Pain neuroscience education versus spinal physiology and ergonomics education in multidisciplinary rehabilitation for chronic low back pain: 12-month follow-up of a randomized controlled trial

Background Pain neuroscience education (PNE) combined with active rehabilitation has been shown to improve outcomes in chronic low back pain; however, its comparative effectiveness with other educational approaches within multidisciplinary rehabilitation programs remains unclear, particularly over longer follow-up periods.Objective To evaluate the effectiveness of pain neuroscience education compared with spinal physiology and ergonomics education(SPEE) within a one-week multidisciplinary rehabilitation program for patients with chronic low back pain at 12-month follow-up.Methods This study reports the 12-month follow-up of a previously published randomized controlled trial. Eighty-eight patients were randomized to the PNE group (n = 44) or the SPEE group (n = 44). Outcomes included disability (Roland-Morris Disability Questionnaire), pain intensity, fear-avoidance beliefs, kinesiophobia (17-item Tampa Scale of Kinesiophobia [TSK-17]), pain catastrophizing, and anxiety-depression, assessed at baseline, post-intervention, 3 months, and 12 months.Results All analyses were done among all randomized patients who had not withdrawn before the start of the rehabilitation program (D0) according to the allocated group to which they were assigned at randomization (n = 74). The between-group difference in disability between baseline and 12 months was not statistically significant (mean difference, −1.04; 95 CI%, −3.14 to 1.06; p = .33). The between-group difference in TSK-17 score significantly favored the PNE group at 12 months(−3.97;95%CI, −7.36 to −0.58; p = .022). No significant between-group differences were observed for pain, pain catastrophizing, anxiety, depression or patient satisfaction.Conclusion At 12 months, PNE improves kinesiophobia scores more than SPEE within a short multidisciplinary rehabilitation program, but does not confer benefits for pain catastrophizing or disability in patients with chronic low back pain.Trial registration ClinicalTrials.gov NCT04179708.