Preoperative pain neuroscience education for shoulder surgery: A case series
Background: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and ca...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2020-08-01
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| Series: | South African Journal of Physiotherapy |
| Subjects: | |
| Online Access: | https://sajp.co.za/index.php/sajp/article/view/1417 |
| _version_ | 1811302574466269184 |
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| author | Adriaan Louw Debra Rico Leigh Langerwerf Nicholas Maiers Ina Diener Terry Cox |
| author_facet | Adriaan Louw Debra Rico Leigh Langerwerf Nicholas Maiers Ina Diener Terry Cox |
| author_sort | Adriaan Louw |
| collection | DOAJ |
| description | Background: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and catastrophisation prior to lumbar and total knee surgery. To date, no study has examined the application of PNE prior to shoulder surgery.
Objectives: This study examined the response to preoperative PNE in patients preparing for shoulder surgery.
Method: An exploratory pre–post case series was conducted. Twelve patients scheduled for surgery completed various pre-education measurements including shoulder pain, fear-avoidance, pain catastrophisation, beliefs and expectations regarding surgery, active shoulder flexion and pressure pain thresholds for the involved and uninvolved shoulder and the dominant-sided knee. Patients underwent a standard 30-min, one-on-one PNE session with a physiotherapist prior to surgery.
Results: Following education, all measures improved with some failing to reach significance: self-reported pain (p = 0.125), pain catastrophisation (p = 0.250) and pain pressure threshold of the uninvolved shoulder (p = 0.68) and knee (p = 0.097). Fear-avoidance (p = 0.013), active shoulder flexion (p = 0.013) and pain pressure threshold for the involved shoulder (p = 0.004) significantly improved.
Conclusion: A small patient group improved beyond minimal detectable change and/or minimal clinical important difference after education. No significant shifts of the preoperative beliefs occurred after education.
Clinical implications: Preoperative PNE may be beneficial to a subgroup of patients scheduled for shoulder surgery. |
| first_indexed | 2024-04-13T07:30:23Z |
| format | Article |
| id | doaj.art-8da82a197cf84de9958288228a317fa2 |
| institution | Directory Open Access Journal |
| issn | 0379-6175 2410-8219 |
| language | English |
| last_indexed | 2024-04-13T07:30:23Z |
| publishDate | 2020-08-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Journal of Physiotherapy |
| spelling | doaj.art-8da82a197cf84de9958288228a317fa22022-12-22T02:56:22ZengAOSISSouth African Journal of Physiotherapy0379-61752410-82192020-08-01761e1e710.4102/sajp.v76i1.14171306Preoperative pain neuroscience education for shoulder surgery: A case seriesAdriaan Louw0Debra Rico1Leigh Langerwerf2Nicholas Maiers3Ina Diener4Terry Cox5Evidence in Motion, San Antonio, United States of AmericaDepartment of Physical Therapy, Rockhurst University, Kansas City, United States of AmericaButte Premier Physical Therapy, Chico, United States of AmericaDepartment of Physical Therapy, Des Moines University, Des Moines, United States of AmericaDepartment of Physiotherapy, Stellenbosch University, Cape TownDepartment of Physical Therapy, Southwest Baptist University, Bolivar, United States of AmericaBackground: Central sensitisation, in addition to high levels of fear-avoidance and pain catastrophisation may exist in a subgroup of patients with shoulder pain. Pain neuroscience education (PNE) has been shown to positively influence sensitivity of the nervous system, as well as reduce fear and catastrophisation prior to lumbar and total knee surgery. To date, no study has examined the application of PNE prior to shoulder surgery. Objectives: This study examined the response to preoperative PNE in patients preparing for shoulder surgery. Method: An exploratory pre–post case series was conducted. Twelve patients scheduled for surgery completed various pre-education measurements including shoulder pain, fear-avoidance, pain catastrophisation, beliefs and expectations regarding surgery, active shoulder flexion and pressure pain thresholds for the involved and uninvolved shoulder and the dominant-sided knee. Patients underwent a standard 30-min, one-on-one PNE session with a physiotherapist prior to surgery. Results: Following education, all measures improved with some failing to reach significance: self-reported pain (p = 0.125), pain catastrophisation (p = 0.250) and pain pressure threshold of the uninvolved shoulder (p = 0.68) and knee (p = 0.097). Fear-avoidance (p = 0.013), active shoulder flexion (p = 0.013) and pain pressure threshold for the involved shoulder (p = 0.004) significantly improved. Conclusion: A small patient group improved beyond minimal detectable change and/or minimal clinical important difference after education. No significant shifts of the preoperative beliefs occurred after education. Clinical implications: Preoperative PNE may be beneficial to a subgroup of patients scheduled for shoulder surgery.https://sajp.co.za/index.php/sajp/article/view/1417educationsurgerypainneuroscienceshoulder |
| spellingShingle | Adriaan Louw Debra Rico Leigh Langerwerf Nicholas Maiers Ina Diener Terry Cox Preoperative pain neuroscience education for shoulder surgery: A case series South African Journal of Physiotherapy education surgery pain neuroscience shoulder |
| title | Preoperative pain neuroscience education for shoulder surgery: A case series |
| title_full | Preoperative pain neuroscience education for shoulder surgery: A case series |
| title_fullStr | Preoperative pain neuroscience education for shoulder surgery: A case series |
| title_full_unstemmed | Preoperative pain neuroscience education for shoulder surgery: A case series |
| title_short | Preoperative pain neuroscience education for shoulder surgery: A case series |
| title_sort | preoperative pain neuroscience education for shoulder surgery a case series |
| topic | education surgery pain neuroscience shoulder |
| url | https://sajp.co.za/index.php/sajp/article/view/1417 |
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