Pain Neuroscience Education in Healthy Children
Condition: Child; Pain
Study type: Interventional

Summary: 
      The primary objective of this study is to examine whether Pain Neuroscience Education for
      children is able to increase a child's knowledge on the neurophysiology of pain.

      In addition, this study investigates the influence of PNE on several pain related outcomes;
      pain-related fear, pain catastrophizing and pain vigilance and awareness.
    

Detailed description: 
      Pain is a common and daily experience among children that is usually short-term, causing
      little to moderate discomfort. Yet, a substantial number of children experience chronic pain.
      Persistent pain periods mainly affect the children's school attendance and participation in
      recreational activities, possibly leading to academic impairments and social exclusion. Even
      worse is the children's greater predisposition to develop chronic pain into adulthood.
      Considering these disadvantages, children suffering from chronic pain should be treated as
      fast as possible and in the most optimal way. The existing literature on management in
      children with chronic pain encourages a multidisciplinary approach involving physical therapy
      and psychological interventions (i.e. cognitive behavioural therapy).

      Recently, the application of Pain Neuroscience Education (PNE) as an intervention on its own,
      as well as in combination with another form of therapy (such as physiotherapy or cognitive-
      behavioural therapy) is receiving growing interest in the pediatric field of chronic pain.
      PNE aims to make people understand how their pain is produced and enables them to integrate
      this understanding into their everyday lives and subsequent treatment components. This
      innovative education style has shown to be effective in various adult chronic pain
      populations, by improving the patients' pain coping strategies and health status, and
      changing their pain beliefs. Although, no study examined the effectiveness of PNE in the
      context of chronic pediatric pain.

      The hypothetical efficacy of pediatric PNE is based on previous findings in adult research
      that a better understanding of the nature of the illness results in improved patient
      outcomes. When children do not understand the origin of their pain, they might develop
      irrational beliefs and fears (including catastrophizing) about their pain, sustaining the
      vicious circle of chronic pain. Indeed, the information and context in which children
      perceive their pain, has been shown to modulate pain expectations and emotional response to
      pain. Since research findings showed that even parental beliefs about the aetiology of the
      child's pain influences the child's pain outcomes, the role of parents as 'pain modulators'
      might not be underestimated. Therefore, parents should be involved during PNE.

      Concrete, the present study will examine whether reconceptualization of pain, by PNE is able
      to influence both child and parent knowledge of pain, as well as some other pain-related
      outcomes.
    

Intervention name(s): Pain Neuroscience Education for children
Intervention type(s): Device
Intervention description(s): Children and their parent will receive a +/- 1h one-on-one educational session about the neurophysiology of pain, adjusted to the child's comprehension status. Parents will be present in the PNE session too. The PNE program for children contains two sections: (1) The healthy pain system and its function, divided in subsections each consisting of a specific neurophysiological pain concept (i.e. central nervous system anatomy, nociception and nociceptive pathways, up- and down-regulation of the nervous system) and (2) adaptations of the pain system following persistent pain. To ensure interaction between therapist and child, an interactive board game was developed and used throughout the full educational session.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pain Neuroscience Education