Therapeutic Exercise Plus Pain Neuroscience Education for Chronic Low Back Pain

\### What is this study about? This study looked at whether adding \*\*pain neuroscience education (PNE)\*\* to standard therapeutic exercise helps people with chronic low back pain who are afraid of moving (a condition called \*kinesiophobia\*). \### Why does it matter? Chronic low back pain is the leading cause of disability worldwide. Many people with chronic back pain develop fear of movement, which makes them avoid exercise and can slow down recovery. While exercise is the recommended first-line treatment, fear of movement often reduces how much patients benefit from it. Pain neuroscience education is a talking therapy that helps patients understand that chronic pain is not always a sign of tissue damage - it often involves the nervous system becoming overly sensitive. The idea is that changing how patients think about pain may reduce their fear and help them engage more fully in exercise. \### What did the researchers do? Patients with chronic low back pain and high fear of movement were randomly assigned to two groups

• \*\*Group 1:\*\* 8 weeks of therapeutic exercise alone
• \*\*Group 2:\*\* 8 weeks of therapeutic exercise \*\*plus\*\* two pain neuroscience education sessions (at the start and at week 4)
• Patients were assessed at \*\*baseline, 8 weeks, and 24 weeks\*\* (6-month follow-up)
• Measures included: fear of movement (TSK-17), pain intensity (NRS), disability (RMDQ), pain catastrophizing (PCS), and central sensitization symptoms (CSI)
• Brain scans (resting-state fMRI) were taken before and after the intervention to explore potential brain-behavior links