Pain Neuroscience Education and Exercise in Institutionalized Older Adults With Pain

Study Overview
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Brief Summary
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The primary objectives of this study are to: Evaluate recruitment procedures and adherence rates; Evaluate the ability to understand the concepts of pain neurophysiology; Evaluate the acceptability of an intervention program based on pain neuroscience education and exercise by institutionalized older adults and the institutions where they are.

Detailed Description
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Participants will be older adults with pain that are institutionalized and assess the feasibility of implementing an intervention consisting of pain neuroscience education in addition to exercise. It is antecipated that the intervention will consist of 1 to 2 sessions per week during 8 weeks and will be delivered in small groups. Participants will be assessed for pain intensity, duration, catastrophizing, fear of movement, knowledge of pain neuroscience, depression and performance.

Official Title
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Pain Neuroscience Education and Exercise in Institutionalized Older Adults With Pain: A Feasibility Study

Conditions
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Chronic Pain

Intervention / Treatment
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* Other: Pain neuroscience education
* Other: Exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be institutionalized in any type of response (nursing home, day care, ...), be able to read and write, have chronic pain (defined as pain lasting 3 months or more and felt at least once a week during these 3 months ) anywhere in the body, and have a statement from the institution's physician authorizing participation in the exercise sessions. Exclusion Criteria: Have any contra-indication to exercise and have cognitive limitations (evaluated through the Montreal Cognitive Assessment questionnaire).

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pain neuroscience and exercise<br>Participants will received an 8 week intervention consisting of pain neuroscience education and exercise. Pain neuroscience education will be conducted in line with international guidelines, covering the neurophysiology of pain, transition from from acute to chronic pain and the nervous system ability to modulate the pain experience. exercise will include general exercise and dance. | Other: Pain neuroscience education<br>* PNE will be conducted in line with international guidelines and will cover the neurophysiology of pain, transition from acute to chronic pain and the nervous system ability to modulate the pain experience.<br>Other: Exercise<br>* Exercise will be provided in different formats including general exercise, strengthening, dance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain intensity | Assessed using the vertical numeric rating scale that assesses pain intensity (range 0-10 and higher values are indicative of higher pain intensity) | Baseline | 
| Pain intensity | Assessed using the vertical numeric rating scale that assesses pain intensity (range 0-10 and higher values are indicative of higher pain intensity) | 9 weeks | 
| Pain intensity | Assessed using the vertical numeric rating scale that assesses pain intensity (range 0-10 and higher values are indicative of higher pain intensity) | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain location | Assessed using a body chart where the patients identifies the painful body segments | Baseline | 
| Pain location | Assessed using a body chart where the patients identifies the painful body segments | 9 weeks | 
| Pain location | Assessed using a body chart where the patients identifies the painful body segments | 3 months | 
| Pain frequency | Assessed using a closed question on pain frequency for the last week | Baseline | 
| Pain frequency | Assessed using a closed question on pain frequency for the last week | 9 weeks | 
| Pain frequency | Assessed using a closed question on pain frequency for the last week | 3 months | 
| Depression | Assessed using the Geriatric Depression Scale (range 0-15 and values of 5 or higher are indicative of depression) | Baseline | 
| Depression | Assessed using the Geriatric Depression Scale (range 0-15 and values of 5 or higher are indicative of depression) | 9 weeks | 
| Depression | Assessed using the Geriatric Depression Scale (range 0-15 and values of 5 or higher are indicative of depression) | 3 months | 
| Knowledge of pain neuroscience | Assessed using the pain neurophysiology questionnaire | Baseline | 
| Knowledge of pain neuroscience | Assessed using the pain neurophysiology questionnaire (range 0-19 and higher values are indicative of more knowledge on pain neurophysiology) | 9 weeks | 
| Knowledge of pain neuroscience | Assessed using the pain neurophysiology questionnaire (range 0-19 and higher values are indicative of more knowledge on pain neurophysiology) | 3 months | 
| Pain catastrophizing | assessed using the Pain Catastrophizing Scale (range 0-52 and higher values are indicative of higher pain catastrophizing) | Baseline | 
| Pain catastrophizing | assessed using the Pain Catastrophizing Scale (range 0-52 and higher values are indicative of higher pain catastrophizing) | 9 weeks | 
| Pain catastrophizing | assessed using the Pain Catastrophizing Scale (range 0-52 and higher values are indicative of higher pain catastrophizing) | 3 months | 
| Fear of movement | Assessed using the TAMPA Scale, which assesses fear of movement (range: 13-52 and higher values are indicative of higher levels of fear of movement) | Baseline | 
| Fear of movement | Assessed using the TAMPA Scale (range: 13-52 and higher values are indicative of higher levels of fear of movement) | 9 weeks | 
| Fear of movement | Assessed using the TAMPA Scale (range: 13-52 and higher values are indicative of higher levels of fear of movement) | 3 months | 
| Gait velocity | Assessed using the gait velocity test - the time, in seconds, that each participant takes to walk 4 meters | Baseline | 
| Gait velocity | Assessed using the gait velocity test - the time, in seconds, that each participant takes to walk 4 meters | 9 weeks | 
| Gait velocity | Assessed using the gait velocity test - the time, in seconds, that each participant takes to walk 4 meters | 3 months | 
| Postural control | Assessed using the Timed up and go test - the time, in seconds, that it takes to stand from a chair, walk 3 meters, turn, walk another 3 meters to sit in the chair. | Baseline | 
| Postural control | Assessed using the Timed up and go test - the time, in seconds, that it takes to stand from a chair, walk 3 meters, turn, walk another 3 meters to sit in the chair. | 9 weeks | 
| Postural control | Assessed using the Timed up and go test - the time, in seconds, that it takes to stand from a chair, walk 3 meters, turn, walk another 3 meters to sit in the chair. | 3 months |