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
BACKGROUND & OBJECTIVE
It has been established that education and training of novice physiotherapists has an influence not only on their own practice in the future, but also on existing practitioners. The absence of a good understanding of pain neurobiology in physiotherapy undergraduate training has been commented on in numerous studies exploring the attitudes and beliefs of physiotherapists. Lack of understanding of pain, and particularly chronic pain, has led to inappropriate recommendations. To reverse this tendency, this study was developed to establish whether students provided training in pain neurophysiology demonstrated altered knowledge, attitudes and clinical recommendations.
72 student physiotherapists in two Universities (one in the UK and one in Ireland) took part in a randomised trial in which one group were provided with a 70-minute group lecture on pain neurophysiology (PNE group), or a control lecture on “red flags” and Waddell’s triaging approach for low back pain. The pain neurophysiology lecture was based on the first four chapters of ‘Explain Pain’ (excellent book on pain science, written in a way that both patients and therapists can understand). Three measures were taken: HC-PAIRS, a measure of attitudes towards patients with chronic pain (taken before the session, and again after the session); Pain Neurophysiology Quiz (PNQ), a measure of pain physiology knowledge (also taken pre and post session); and a case vignette provided to each participant before and after the session to assess the recommendations made in terms of daily activities, work, exercise and bed rest.
Improvement in scores on the PNQ and HC-PAIRS were obtained in both groups, but participants in the PNE group showed a greater increase in knowledge on the PNQ, and a greater shift in positive attitudes towards people with chronic pain.