Flipping Patients' Understanding of Pain—Flipped Learning Pain Education Model in Physical Therapy

BACKGROUND: Chronic pain affects more than 1 in 5 adults in the United States. Our understanding of pain has improved, particularly regarding psychosocial factors. Compelling evidence supports pain neuroscience education for chronic pain, but the best methods for implementation in clinical practice remain unclear. OBJECTIVE: The aim was to evaluate the impact of a flipped learning pain education model in physical therapy on the function of patients with chronic pain. In addition, the purpose was to describe the predicted and actual number of physical therapy visits in this population. METHODS: A retrospective, uncontrolled single-therapist chart review was conducted. Adults diagnosed with chronic pain who received physical therapy using the flipped learning pain education model and had pre- and post-rehabilitation Patient-Specific Functional Scale (PSFS) scores were included. The main outcome was change in the PSFS. The number of predicted visits was derived from the Focus on Therapeutic Outcomes tool. RESULTS: A total of 28 individuals (68% women) were identified. PSFS scores significantly increased from a median of 2.0 (interquartile range, IQR 3.2) to 8.6 (IQR 2.9) (p < 0.001). At baseline, the median predicted number of visits was 12.0 (IQR 4.0), while the median actual visits were 5.0 (IQR 1.8). A total of 24 patients (85.7%) achieved or exceeded the minimal clinically important difference. CONCLUSIONS: PSFS scores were higher at the final recorded visit in this selected complete-case cohort receiving physical therapy using a flipped learning model. The findings should be interpreted with caution due to the exploratory nature of the study.