INTRODUCTION: Chronic low back pain (CLBD) is one of the major public health problems in the world. Given the complexity of the situation, complementary and alternative practices such as pain neuroscience education (PNE), clinical hypnosis (HC) and osteopathic manipulative treatment (OMT) are options for we manage these patients. OBJECTIVE: The aim of this study will be to evaluate the effects of OMT associated with PNE through HC on pain and disability in patients with CLBP compared to PNE and HC. MATERIALS AND METHODS: The study design will be a randomized clinical trial and 40 adults diagnosed with chronic low back pain will be recruited. Subjects will be randomized in two groups: the first group (G1) will be submitted to the PNE based on information from the book "Explain Pain" with hypnotic suggestions. Group 2 (G2) will receive PNE following the book "Explain Pain" with hypnotic suggestions associated with OMT. Volunteers will be evaluated by a blind researcher the interventions performed in the allocation of groups. The evaluation moments will be pre-intervention and immediately after the end of the last intervention for G1 and G2. Volunteers continued to be evaluated 4 weeks after completion of the protocols. Pain will be evaluated as the main outcome, being evaluated by the numerical pain scale. Pain will also be assessed by the pressure threshold using a pressure algometer device (Fnd-50, PIAB 50-n, Italy) in the lumbar region. Still as the main outcome, disability will be assessed using the Oswestry Disability Questionnaire. As secondary outcomes, the patient's global impression of improvement, central sensitization, biopsychosocial factors will be evaluated. The patient's global impression of improvement will be assessed using the Percentage of Improvement Scale with a score of -5 to +5; the Central Sensitization will be assessed using the Central Sensitization Questionnaire and the biopsychosocial factors using the Start Beck Toll questionnaire. In addition, the behavior of the autonomic nervous system will be evaluated through the Heart Rate Variability (HRV), which will be analyzed through linear methods, in the domains of time and frequency, and by geometric indices. The researcher/evaluator will be blinded to the allocation of intervention groups. Given the nature of the study, it is impossible to blind the researcher/therapist and volunteers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Will be performed education in pain neurosciences and clinical hypnosis, in 4 sessions during 4 weeks
Will be performed education in pain neurosciences and clinical hypnosis, and only for this group will be delivered osteopathic manipulative treatment, in 4 sessions during 4 weeks
Anne Kastelianne
Presidente Prudente, São Paulo, Brazil
Pain perception
The Pain suffered in the last week will be assessed by the Numerical pain scale, with a range of 0 - 10
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
Pain pressure threshold
Pain will be assessed by the pressure threshold using a pressure algometer device in the lumbar region. The assessment will be conducted specifically in the paravertebral muscles bilaterally at levels L1 to L5.
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
Disability
Disability will be assessed using the Oswestry Disability Questionnaire
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
Patient's global impression of improvement
The patient's global impression of improvement will be assessed using the Percentage of Improvement Scale with a score of -5 to +5
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
Central Sensitization and biopsychosocial factors
The Central Sensitization Questionnaire and the biopsychosocial factors will be assessed using the Start Beck Toll questionnaire
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
Heart Rate Variability
Heart Rate Variability, which will be analyzed through linear methods, in the domains of time and frequency, and by geometric indices
Time frame: T0= before the protocol; T1= until 24 hours after the end protocol; T2= four weeks after end protocols
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