Background & Aims
A clear understanding of current concepts of pain and related areas is required for establishing a standardized and consistent assessment, and formulation of an appropriate treatment plan. Education on the topic of pain is still fragmented and inadequate in the undergraduate and postgraduate physiotherapy curriculum in India. Therefore, there is a need of multidisciplinary training with reference to pain science education among Indian Physiotherapists to facilitate physiotherapist’s knowledge, attitude, and belief with selecting treatments that are commonly prescribed for patients with chronic pain in an Indian clinical setting to improve the clinical outcomes.
Overarching aim of this research project is to educate and create awareness among Indian physiotherapists for better clinical outcomes in common musculoskeletal conditions.
Methods
Following ethical approval, a hybrid model of multidisciplinary training was devised based on the IASP curriculum for physiotherapists. The research design employed in this project was a pre-test and post-test approach. A diverse sample of 125 physiotherapy professionals, meeting specific inclusion criteria, actively participated in the training program. Educational materials were developed and translated in one of the official language (Marathi language), ensuring accessibility and cultural relevance. Pain education training was conducted through a hybrid mode, combining online lectures (total 12 hours) with in-person training sessions (total 8 hours) over a four-week period.
Results
The study assessed outcomes using the Revised Neurophysiology of Pain Questionnaire (RNPQ) and the Pain Attitude and Beliefs Scale (PABS) for Physiotherapists, both administered before and after the training program.
For RNPQ each question was analyzed by difference between pre and post analysis, shows the total number of correct and incorrect responses. The Chi-square test values and p-values demonstrate the statistical significance of the observed differences.
The paired samples test was used to compare pre-test and post-test scores for two factors, PABS factor 1(Biomedical) and PABS factor 2 (Biopsychosocial).
The results showed significant differences between pre-test and post-test scores for both PABS Factor 1 (Biomedical) Mean Difference = 5.416 and PABS Factor 2 (Biopsychosocial) Mean Difference = -17.472.
The results showed significant differences between pre-test and post-test scores for all questions within both factors, as well as for the total scores.
Conclusions
In conclusion, this education project provides compelling evidence supporting the highly effective nature of pain education training in enhancing the knowledge, confidence, and clinical competencies of physiotherapy professionals in the realm of pain management. These positive outcomes have far-reaching benefits, not only for the professionals themselves but also for the improvement of patient care and overall health outcomes for individuals suffering from chronic pain.
References
1. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. The Lancet. 2021 May 29;397(10289):2082-97.
2. Holopainen, R., Vuoskoski, P., Piirainen, A., Karppinen, J. and O’Sullivan, P., 2022. Patients’ conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy. Disability and rehabilitation, 44(14), pp.3388-3399.
3. Bellosta-López, P., Blasco-Abadía, J., BelsuéPastora, J., Hoegh, M.S., Palsson, T.S., Christensen, S.W.M.P., Berjano, P.L., Langella, F., Vanni, D., de Brito Silva, P. and Jensen, P.S., 2022. Good practice guidelines for pain and musculoskeletal disorders in workers and companies.
4. Harhara, T. and Ibrahim, H., 2021. Undergraduate palliative care education in the United Arab Emirates: a nationwide assessment of medical school deans. BMC medical education, 21(1), pp.1-8.
5. Tatta, J., Nijs, J., Elma, Ö., Malfliet, A. and Magnusson, D., 2022. The critical role of nutrition care to improve pain management: a global call to action for physical therapist practice. Physical Therapy, 102(4), p.pzab296.
6. Sussmann, K.E., Jacobs, H. and Hoffmann, F., 2021, November. Physical Therapy Use and Associated Factors in Adults with and without Osteoarthritis—An Analysis of the Population-Based German Health Update Study. In Healthcare (Vol. 9, No. 11, p. 1544). MDPI.
7. Bansal D, Asrar MM, Ghai B, Pushpendra D. Prevalence and Impact of Low Back Pain in a Community-Based Population in Northern India. Pain Physician. 2020;23(4):E389- E398.
8. Bang AA, Bhojraj SY, Deshmukh M, et al. Epidemiology of pain in back and extremities in rural population: A community-based estimation of age- and sex-specific prevalence, distribution, duration and intensity of pain, number of painful sites and seasonality of pain during twelve months in rural Gadchiroli, India. J Glob Health. 2021;11:12002. doi:10.7189/jogh.11.12002
9. Buchbinder R, van Tulder M, Öberg B, et al. Low back pain: a call for action. The Lancet. 2018;391(10137):2384-2388. doi:10.1016/S0140-6736(18)30488-4
10. Barbari V, Storari L, Ciuro A, Testa M. Effectiveness of communicative and educative strategies in chronic low back pain patients: A systematic review. Patient Educ Couns. 2020;103(5):908-929. doi:10.1016/j.pec.2019.11.031
11. King R, Robinson V, Elliott-Button HL, Watson JA, Ryan CG, Martin DJ. Pain Reconceptualisation after Pain Neurophysiology Education in Adults with Chronic Low Back Pain: A Qualitative Study. Pain Res Manag. 2018;2018:1-10. doi:10.1155/2018/3745651
12. Hurley J, O’Keeffe M, O’Sullivan P, Ryan C, McCreesh K, O’Sullivan K. Effect of education on non-specific neck and low back pain: A meta-analysis of randomized controlled trials. Man Ther. 2016;23:e1-e2. doi:10.1016/j.math.2016.02.009
13. Moseley GL. Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain. Eur J Pain. 2004;8(1):39-45. doi:10.1016/S1090-3801(03)00063-6
14. Moseley GL. Reconceptualising pain according to modern pain science. Phys Ther Rev. 2007;12(3):169-178. doi:10.1179/108331907X223010
15. Louw A, Zimney K, O’Hotto C, Hilton S. The clinical application of teaching people about pain. Physiother Theory Pract. 2016;32(5):385-395. doi:10.1080/09593985.2016.1194652.
16. Driver C, Kean B, Oprescu F, Lovell GP. Knowledge, behaviors, attitudes and beliefs of physiotherapists towards the use of psychological interventions in physiotherapy practice: a systematic review. Disabil Rehabil. 2017;39(22):2237-2249. doi:10.1080/09638288.2016.1223176
17. Holopainen R, Simpson P, Piirainen A, et al. Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions: a systematic review and metasynthesis of qualitative studies. Pain. 2020;161(6):1150-1168. doi:10.1097/j.pain.0000000000001809
18. Mukhtar NB, Meeus M, Gursen C, Mohammed J, Dewitte V, Cagnie B. Development of culturally sensitive pain neuroscience education materials for Hausa-speaking patients with chronic spinal pain: A modified Delphi study. Abaraogu UO, ed. PLOS ONE. 2021;16(7):e0253757. doi:10.1371/journal.pone.0253757.
19. Sharma S, Jensen MP, Moseley GL, Abbott JH. Pain education for patients with non- specific low back pain in Nepal: protocol of a feasibility randomised clinical trial (PEN- LBP Trial). BMJ Open. 2018;8(8):e022423. doi:10.1136/bmjopen-2018-022423.
20. Sharma S, Jensen MP, Moseley GL, Abbott JH. Results of a feasibility randomised clinical trial on pain education for low back pain in Nepal: the Pain Education in Nepal- Low Back Pain (PEN-LBP) feasibility trial. BMJ Open. 2019;9(3):e026874. doi:10.1136/bmjopen-2018-026874
Presenting Author
Rinkle Malani
Poster Authors
Rinkle Malani
Lead Author
Dr. Prashant Mukkannavar
PhD
KLE College of Physiotherapy, Hubballi
Lead Author
Tajuddin Chitapure
MPT
MGM School of Physiotherapy
Lead Author
Vaibhavi walimbe
MPT
MGM School of Physiotherapy
Lead Author
Utkarsha Kawathekar
MPT
MGM School of Physiotherapy
Lead Author
Topics
- Education