Effects of Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students

NCT07005778 | Completed

• 1 other identifier: 03.10.2024, TBAEK-683
• Study Type: interventional
• Target: 41
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. The main questions this study aims to answer are: Does a single-session PNE-based education improve students' beliefs about the relationship between pain and disability? Does it reduce reliance on biomedical (organic) pain beliefs compared to traditional pain education? In this study, researchers will compare PNE-based education to traditional pain education, both delivered through 70-minute lectures. Participants were randomly assigned to either the PNE group or the traditional education group, attended a one time 70-minute classroom lecture, completed questionnaires at three time points: before the session, immediately after, and 3 months later. The main tools used will be the Health Care Providers' Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Pain Beliefs Questionnaire (PBQ), which includes organic and psychological subscales. This study aims to support the integration of contemporary pain neuroscience content into physiotherapy assistant curricula to enhance biopsychosocial understanding at an early stage of professional education.

Conditions

Musculoskeletal Pain

Outcome Measures

Primary Outcomes (1)

• The Health Care Pain Attitudes and Impairment Relationship Scale

  The HC-PAIRS is a 12-item scale that measures healthcare providers' beliefs about how much pain leads to disability in low back pain cases, using a 7-point Likert scale. Higher scores indicate more negative attitudes. The Turkish version was validated and showed strong reliability (ICC = 0.85).

  Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.

Secondary Outcomes (1)

• Pain Beliefs Questionnaire

  Participants completed the Pain Beliefs Questionnaire at baseline, Day 1 and 3 months

Study Arms (2)

Traditional Pain Education

ACTIVE COMPARATOR

Participants in the control group received a 70-minute lecture based on the biomedical model of pain.

Other: Traditional pain education

PNE based education

EXPERIMENTAL

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain.

Other: PNE-based education

Interventions

Traditional pain education OTHER

Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury.

Traditional Pain Education

PNE-based education OTHER

Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors. Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience.

PNE based education

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Students were eligible to participate if they were undergraduate physiotherapy assistant students enrolled at the Vocational School of Health Services.

You may not qualify if:

• Individuals were excluded if they had previously received in-depth teaching on pain neurophysiology or traditional pain education.

Sponsors & Collaborators

• Akdeniz University: lead
• Pamukkale University: collaborator

Study Sites (1)

Akdeniz University

Antalya, Konyaaltı, 07070, Turkey (Türkiye)

Location

Related Publications (3)

• Mankelow J, Ryan C, Taylor P, Martin D. The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial. Musculoskelet Sci Pract. 2020 Dec;50:102249. doi: 10.1016/j.msksp.2020.102249. Epub 2020 Aug 28.

  PMID: 32920228 RESULT

• Cox T, Louw A, Puentedura EJ. An abbreviated therapeutic neuroscience education session improves pain knowledge in first-year physical therapy students but does not change attitudes or beliefs. J Man Manip Ther. 2017 Feb;25(1):11-21. doi: 10.1080/10669817.2015.1122308. Epub 2016 Feb 10.

  PMID: 28855788 RESULT

• Colleary G, O'Sullivan K, Griffin D, Ryan CG, Martin DJ. 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. Physiotherapy. 2017 Dec;103(4):423-429. doi: 10.1016/j.physio.2017.01.006. Epub 2017 Mar 22.

  PMID: 28797666 RESULT

MeSH Terms

Conditions

Musculoskeletal Pain

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Hatice Gül

  Akdeniz University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of Therapy and Rehabilitation Department of Vocational School of Health Services

Study Record Dates

• First Submitted: May 26, 2025
• First Posted: June 5, 2025
• Study Start: December 12, 2024
• Primary Completion: December 12, 2024
• Study Completion: March 12, 2025
• Last Updated: June 5, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)