Pain Neuroscience Education Following Arthroscopic Rotator Cuff Repair
Condition: Rotator Cuff Injuries; Tear; Pain, Shoulder
MeSH terms: Shoulder Pain; Rotator Cuff Injuries
Study type: Interventional

Summary: 
      Pain neuroscience education (PNE) aims to explain to patients the biological and
      physiological processes involved in a pain experience and, more importantly, defocus the
      issues associated with the anatomical structures. It has been demonstrated for
      musculoskeletal pain, PNE provides compelling evidence in reducing pain, disability, pain
      catastrophization, and limited physical movement. Rotator cuff tears (RCT) often lead to pain
      aggrevation, deterioration of patients' functioning and considerable economic burden for
      health care resources requiring consultations, physiotherapy, radiological examinations and
      surgery. Despite costly arthroscopic surgeries and long-term physiotherapy treatments,
      satisfactory results are scarce. The lack of satisfactory results at the end of all this
      effort suggests that some practices should be revised. Although PNE is likely to have
      beneficial effects on shoulder pathomechanics, to our knowledge, there is no randomized
      controlled research in the relevant literature investigating the effects of PNE in patients
      with an RCT. The present study aims to examine the effectiveness of PNE on clinical outcomes
      in a sample of patients with RCT.
    

Detailed description: 
      Therapeutic interventions based on pain neuroscience education (PNE) have emerged as
      promising. It consists of educational sessions describing the neurobiology and
      neurophysiology of chronic pain and pain processing, with a particular focus on the role of
      the central nervous system on chronic pain and deemphasizing anatomical issues. PNE promotes
      the patients' understanding of chronic pain and changes maladaptive thoughts and cognitions
      (e.g. pain catastrophizing), which are important barriers to active therapy and exercise.
      Despite the apparent complexity of neuroscience education, patients are able to understand
      and remember it. Furthermore, there is evidence that an educational strategy addressing
      neurophysiology and neurobiology of pain can have a positive effect on pain, disability,
      catastrophizing, and physical performance, especially if combined with exercise. Rotator cuff
      tears (RCT) often lead to pain aggrevation, deterioration of patients' functioning and
      considerable economic burden for health care resources requiring consultations,
      physiotherapy, radiological examinations and surgery. Despite costly arthroscopic surgeries
      and long-term physiotherapy treatments, satisfactory results are scarce. The lack of
      satisfactory results at the end of all this effort suggests that some practices should be
      revised. Although PNE is likely to have beneficial effects on shoulder pathomechanics, to our
      knowledge, there is no randomized controlled research in the relevant literature
      investigating the effects of PNE in patients with an RCT. The present study aims to examine
      the effectiveness of PNE on clinical outcomes in a sample of patients with RCT.
    

Intervention name(s): Pain neuroscience education; Conventional treatment
Intervention type(s): Other; Other
Intervention description(s): The experimental group will follow a PNE protocol based on previous procedure for a whole period of 6 weeks in addition the conventional treatment.; Patients from both groups will receive a conventional 6-week treatment programme (30 treatment sessions, five a week, for 90min duration).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rotator Cuff Injuries; tear; pain; shoulder