Effect of pain neurophysiology education on physiotherapy students understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial

Objective To investigate the effect of pain neurophysiology education (PNE) on student physiotherapists’: (1) knowledge of chronic pain;(2) attitudes towards patients with chronic pain; and (3) clinical recommendations for patients with chronic pain.Design Multicentre single-blind randomised controlled trial.Setting One UK and one Irish university.Participants Seventy-two student physiotherapists.Intervention Participants received either PNE (intervention) or a control education. Both were delivered in a 70-minute group lecture.Main outcome measures (1) The Revised Pain Neurophysiology Quiz to assess knowledge; (2) the Health Care Pain Attitudes and ImpairmentRelationship Scale (HC-PAIRS) to assess attitudes; and (3) a case vignette to assess the appropriateness of clinical recommendations.Results Post education, the PNE group had a greater increase in pain neurophysiology knowledge [mean difference 4.0 (95% confidenceinterval 3.2 to 4.7), P < 0.01] and more improved attitudes [−17.5 (95% confidence interval −22.1 to −12.9), P < 0.01] compared with thecontrol group. Post education, students in the PNE group were more likely to make appropriate recommendations regarding work (94% vs56%), exercise (92% vs 56%), activity (94% vs 67%) and bed rest (69% vs 33%) compared with those in the control group (P < 0.05).Conclusion The improvements in knowledge, attitudes and recommendations for pain management show that PNE is a potentially valuablepart of the education of physiotherapy students, and could be used on a more widespread basis. There is a need to investigate whether thesefindings can be replicated in other healthcare professions, and how well these reported changes lead to changes in actual clinical behaviourand the clinical outcomes of patients.