Pain Neuroscience Education and Exercise for Chronic Nonspecific Low Back Pain

NCT07202533 | Active Not Recruiting

• 1 other identifier: Hacettepe-FTR-AŞ-01
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effects of adding Pain Neuroscience Education (PNE) to motor control exercises in individuals with chronic non-specific low back pain (CNSLBP) who also present with central sensitization. The study focuses on changes in pain intensity, pain-related factors, trunk muscle activation, gait, functionality, kinesiophobia, and quality of life.

Conditions

Chronic Non-specific Low Back Pain

Keywords

low back pain; central sensitization; surface electromyography; pain neuroscience education; motor control exercise

Outcome Measures

Primary Outcomes (6)

• Pain Intensity (Numerical Pain Rating Scale - NPRS)

  Change in pain intensity will be assessed using a 0-10 Numerical Pain Rating Scale at baseline and post-intervention. Higher scores indicate greater pain severity.

  Baseline and post-intervention (8 weeks)

• Pressure Paın Threshold Measurement

  PPT will be measured using a digital algometer on the lumbar region. Higher values indicate reduced pain sensitivity.

  Baseline and post-intervention (8 weeks)

• Central Sensitization (Central Sensitization Inventory - CSI)

  The CSI-A section will be used to evaluate symptoms related to central sensitization. Total scores range from 0-100, with higher scores indicating greater sensitization.

  Baseline and post-intervention (8 weeks)

• Pain Knowledge (Revised Neurophysiology of Pain Questionnaire - rNPQ)

  Participants' knowledge about pain neurophysiology will be assessed. The number of correct responses will be calculated.

  Baseline and post-intervention (8 weeks)

• Disability (Roland-Morris Disability Questionnaire - RMDQ)

  Functional disability due to low back pain will be assessed using the RMDQ, a 24-item self-report questionnaire.

  Baseline and post-intervention (8 weeks)

• Muscle Activation (Surface EMG Analysis)

  Surface EMG will evaluate activation levels of bilateral external oblique, internal oblique, transversus abdominis, and tibialis anterior muscles during gait.

  Baseline and post-intervention (8 weeks)

Secondary Outcomes (5)

• Kinesiophobia (Tampa Scale for Kinesiophobia - TSK)

  Baseline and post-intervention (8 weeks)

• Pain Catastrophizing (Pain Catastrophizing Scale - PCS)

  Baseline and post-intervention (8 weeks)

• Gait Analysis (OptoGait Photocell System)

  Baseline and post-intervention (8 weeks)

• Gait Analysis (Noraxon Ultium Insole)

  Baseline and post-intervention (8 weeks)

• Quality of Life (Nottingham Health Profile - NHP)

  Baseline and post-intervention (8 weeks)

Study Arms (2)

Motor Control Exercises

ACTIVE COMPARATOR

This group will receive motor control exercises only.

Other: Motor Control Exercises

Motor Control Exercises + Pain Neuroscience Education

EXPERIMENTAL

This group will receive the same motor control exercise program as the control group, plus a 6-week PNE program delivered once per week. The PNE program consists of 6 weekly sessions, delivered via slide presentations and interactive discussions, covering topics such as nociception, central sensitization, neuroplasticity, and pain coping strategies. Sessions are delivered by a certified physiotherapist.

Other: Pain Neuroscience Education; Other: Motor Control Exercises

Interventions

Motor Control Exercises OTHER

Participants will perform these exercises under physiotherapist supervision twice per week for 8 weeks. Exercises focus on improving deep trunk muscle coordination and stability.

Motor Control Exercises

Pain Neuroscience Education OTHER

A 6-week educational program with weekly sessions using slide presentations and interactive discussions, covering pain neurophysiology, central sensitization, and pain coping strategies, delivered by a certified physiotherapist.

Motor Control Exercises + Pain Neuroscience Education

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Volunteers who agree to participate in the study
• Having a history of non-specific low back pain lasting at least 3 months
• Having a pain intensity score of 3 or higher on the Numerical Pain Rating Scale (NPRS) within the last week
• Scoring ≥28 on the Turkish version of the Central Sensitization Inventory.

You may not qualify if:

• Individuals with radicular symptoms or cauda equina syndrome
• Severe osteoporosis
• Spondyloarthropathy
• Spondylolisthesis
• Lumbar spinal stenosis
• Lumbar fractures
• Malignant tumors
• Severe comorbidities (neurological, neuromuscular, cardiac, or psychiatric disorders)
• Individuals who have undergone spinal surgery
• Individuals who are familiar with motor control exercises or who have previously received pain neuroscience education

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University

Ankara, Karabük Province, 06100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

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: → PhD Candidate, Research Assistant

Model Details: Participants will be randomly assigned to either a control group receiving motor control exercises or an intervention group receiving motor control exercises plus PNE. Both groups will receive treatment twice weekly for 8 weeks.

Study Record Dates

• First Submitted: September 2, 2025
• First Posted: October 1, 2025
• Study Start: August 29, 2024
• Primary Completion: August 8, 2025
• Study Completion: March 31, 2026
• Last Updated: February 20, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)