The Efficacy of Pain Neuroscience Education on Active Rehabilitation Following Arthroscopic Rotator Cuff Repair: A CONSORT-Compliant Prospective Randomized Single-Blind Controlled Trial

Abstract

Pain neuroscience education (PNE), a modern educational therapy, has been reported to be effective in pain control by reducing fear of movement. This study investigated the effects of additional PNE on a physical therapy rehabilitation protocol (PTRP) following arthroscopic rotator cuff repair (ARCR). In this single-blind, randomized controlled trial, 34 patients who had undergone ARCR were randomly allocated (1:1) into two groups: PNE (PTRP plus PNE) and PTRP. PTRP was performed five times a week, for four weeks, 115 min per session (physical agents, manual therapy, and exercises), and PNE was performed twice at the beginning (face-to-face PNE) and end (non-face-to-face) of the PTRP. The outcome measures were measured four times for pain intensity, pain cognition, and shoulder function; two times for a range of motion; and once for satisfaction. No significant difference in pain intensity was observed between the groups. However, in pain cognition, the Tampa Scale for Kinesiophobia avoidance showed a significant interaction between time and group, and PNE showed a higher effect size than PTRP in the post-test and follow-up in several variables. In conclusion, the significant improvement in avoidance in postoperative rehabilitation suggests that there is a partially positive benefit in terms of pain, range of motion, and shoulder function in ARCR patients.