Andias R.1, Neto M.1, Silva A.1,2
1University of Aveiro, School of Health Sciences, Aveiro, Portugal, 2University of Aveiro, CINTESIS.UA, Aveiro, Portugal
Background: Neck pain prevalence and associated disability is high and has been increasing over the last decades in adolescents aged 16 to 18 years old. Pain neuroscience education has been shown to have positive effects on pain and disability when applied to adults and in clinical contexts. Nevertheless, studies of school-based pain neuroscience education for adolescents are lacking.
Purpose: To compare the effectiveness of 4 sessions of pain neuroscience education and neck/shoulder exercises delivered over 4 weeks with no intervention for adolescents with chronic idiopathic neck pain.
Methods: 43 adolescents aged 16 to 18 years old and with chronic idiopathic neck pain were randomly allocated to receive pain neuroscience education and shoulder/neck exercises (n=21) or no intervention (n=22). Data on pain intensity, pain disability, neck flexor and extensor muscles endurance, scapular stabilizers endurance, pain catastrophizing, anxiety and knowledge of pain neurophysiology were collected. Measurements were taken before and after the intervention.
Results: All participants completed the study and attended all the 4 treatment sessions. Analysis using a mixed-methods ANOVA revealed a significant group by time interaction suggesting a benefit of the intervention for neck extensors endurance (mean±SD change in the intervention group vs. no intervention group=+49.9±77.3s vs. +11.9±42.5s), pain catastrophizing (mean±SD change=-6.2±6.5 vs. -1.9±4.1) and knowledge of pain neurophysiology (mean±SD change= +9.9±3.2 vs. -0.7±2.4). Furthermore, a significant effect of group and of time was found for pain intensity (mean±SD change= -1.0±1.7 vs. -0.4±1.9), neck flexors (mean±SD change=+16.7±24.4s vs. +3±12.7s) and scapular stabilisers endurance (mean±SD change= +25.9±22.5 vs. +14.2±28.1). No significant differences were found for disability and anxiety.
Conclusion(s): Results support the use of pain neurophysiology education and exercise for adolescents with chronic idiopathic neck pain. Further studies are needed to confirm these results.
Implications: The significant improvement after the intervention for most of the variables assessed suggests that pain neuroscience education combined with exercise may be a valuable intervention for adolescents with neck pain. Furthermore, the adherence of participants to the intervention suggests that it could be applied within the school setting increasing the probability of reaching a higher number of students with pain.
Funding acknowledgements: No funding received.
Topic: Musculoskeletal: spine
Ethics approval: Committee of the Social and Health Sciences Department, Faculty of Medicine, University of Porto (reference 4/2015). Trial registration number NCT02827994.
All authors, affiliations and abstracts have been published as submitted.
