Key result
Perioperative pain neuroscience education improved health utility values more than biomedical education in patients with higher preoperative kinesiophobia (P=0.02) and leg pain intensity (P=0.02).
Why the study?
To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the effectiveness of perioperative pain neuroscience education on health-related quality of life after lumbar radiculopathy surgery.
Does perioperative pain neuroscience education improve health-related quality of life in adults receiving surgery for lumbar radiculopathy?
RCT (n=90)
triple-blinded
1:1
Yes
Does perioperative pain neuroscience education improve health-related quality of life in adults receiving surgery for lumbar radiculopathy?
Perioperative pain neuroscience education may be more effective than biomedical education for improving postoperative health utility in patients with higher baseline kinesiophobia and leg pain intensity undergoing surgery for lumbar radiculopathy.
May support selecting PPNE for patients with higher preoperative kinesiophobia or leg pain; hypothesis-generating moderator analysis requires prospective confirmation.
OBJECTIVE: To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the established effectiveness of perioperative pain neuroscience education (PPNE) on health-related quality of life at 1 year after surgery for lumbar radiculopathy. DESIGN: Secondary analysis of a triple-blinded randomized controlled trial. METHODS: Participants (n = 90) were Dutch-speaking adults (18-65 years) who were scheduled for surgery for lumbar radiculopathy in 3 Belgian hospitals. They were randomized (1:1) to receive PPNE (n = 41) or perioperative biomedical education (n = 49). Linear mixed models were built for health-related quality of life (ie, SF-6D utility values, Physical and Mental Component of the 36-item Short Form Health Survey) using the following independent variables: therapy, time, and preoperative scores for back and leg pain intensity, pain catastrophizing, kinesiophobia, hypervigilance, and quantitative sensory measures. RESULTS: The impact of PPNE on SF-6D utility values over time was influenced by kinesiophobia (F = 3.30, P = .02) and leg pain intensity (F = 3.48, P = .02). Regardless of the intervention, back pain intensity negatively influenced SF-6D values over time (F = 3.99, P = .009). The Physical Component scores were negatively impacted by back pain intensity (F = 9.08, P = .003) and were influenced over time by leg pain intensity (F = 2.87, P = .04). The Mental Component scores were negatively impacted by back pain intensity (F = 6.64, P = .01) and pain catastrophizing (F = 5.42, P = .02), as well as hypervigilance (F = 3.16, P = .03) and leg pain intensity (F = 3.12, P = .03) over time. CONCLUSION: PPNE may be more effective than perioperative biomedical education in improving postoperative health utility values in patients who reported higher kinesiophobia and leg pain intensity before surgery for lumbar radiculopathy. J Orthop Sports Phys Ther 2024;54(4):279-288. Epub 8 January 2024. doi:10.2519/jospt.2024.12051
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Bogaert et al. (2024) conducted an RCT in lumbar radiculopathy (n=90). perioperative pain neuroscience education (PPNE) vs. perioperative biomedical education was evaluated on health-related quality of life at 1 year. Perioperative pain neuroscience education improved health utility values more than biomedical education in patients with higher preoperative kinesiophobia (P=0.02) and leg pain intensity (P=0.02).
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