Musculoskeletal science & practice · 2026
Adding the short, digital PainSMART-educational strategy whilst patients with musculoskeletal pain wait for primary care physiotherapy: A randomised controlled trial.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Thompson Richard, Fors Maria, Kammerlind Ann-Sofi, Tingström Pia, Abbott Allan, Johansson Kajsa
Аннотация
OBJECTIVES: Does adding the PainSMART-strategy to usual physiotherapy management of musculoskeletal pain (MSKP) improve pain intensity, pain self-efficacy and selected secondary outcomes?
DESIGN: A multi-centre randomised, control group-blinded, superiority trial. Adults seeking primary care physiotherapy with MSKP were randomly allocated to usual physiotherapy management alone (n = 250), or usual physiotherapy management plus the PainSMART-strategy (n = 254); a 7-min pain science education (PSE) film and short physiotherapist-initiated reflection on the film. Data were collected at baseline, follow-ups 1 (24-72hrs pre-physiotherapy consultation), 2 (24hrs post-consultation) and 3 (three months post-baseline).
PRIMARY OUTCOMES: Average pain intensity and pain self-efficacy.
SECONDARY OUTCOMES: Best/worst pain intensity, MSKP-perceptions, MSKP-coping strategies, psychological flexibility, physical activity levels, sitting time, global rating of change.
RESULTS: Average pain intensity: No between-group difference in change from baseline to any follow-up (MD -0.06, 95% CI -0.36 to 0.25, 0-10 scale; 0.05, 95% CI -0.34 to 0.43; -0.08, 95% CI -0.54 to 0.37). Pain self-efficacy: Between-group difference in change from baseline favoured the PainSMART-group at follow-up 1 (MD 1.6, 95% CI 0.10 to 3.0, 0-60 scale; exploratory analysis), but not follow-ups 2 and 3 (MD -0.07, 95% CI -1.8 to 1.6; 1.3, 95% CI -1.0 to 3.6; primary analysis time points). Fewer patients in the PainSMART-group reported worsening.
CONCLUSION: Combining the PainSMART-strategy with usual physiotherapy management did not result in additional clinically meaningful benefits once physiotherapy had commenced. During waiting times, the strategy may facilitate earlier improvements in MSKP-perceptions, self-efficacy and physical activity for some. This type of educational intervention is scalable within primary care.
CLINICAL TRIALS REGISTRATION: The study protocol (2023-12-15) and statistical analysis plan (2024-09-25) were prospectively registered at ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT06187428) and the study protocol published (https://doi.org/10.1371/journal.pone.0316806).
DESIGN: A multi-centre randomised, control group-blinded, superiority trial. Adults seeking primary care physiotherapy with MSKP were randomly allocated to usual physiotherapy management alone (n = 250), or usual physiotherapy management plus the PainSMART-strategy (n = 254); a 7-min pain science education (PSE) film and short physiotherapist-initiated reflection on the film. Data were collected at baseline, follow-ups 1 (24-72hrs pre-physiotherapy consultation), 2 (24hrs post-consultation) and 3 (three months post-baseline).
PRIMARY OUTCOMES: Average pain intensity and pain self-efficacy.
SECONDARY OUTCOMES: Best/worst pain intensity, MSKP-perceptions, MSKP-coping strategies, psychological flexibility, physical activity levels, sitting time, global rating of change.
RESULTS: Average pain intensity: No between-group difference in change from baseline to any follow-up (MD -0.06, 95% CI -0.36 to 0.25, 0-10 scale; 0.05, 95% CI -0.34 to 0.43; -0.08, 95% CI -0.54 to 0.37). Pain self-efficacy: Between-group difference in change from baseline favoured the PainSMART-group at follow-up 1 (MD 1.6, 95% CI 0.10 to 3.0, 0-60 scale; exploratory analysis), but not follow-ups 2 and 3 (MD -0.07, 95% CI -1.8 to 1.6; 1.3, 95% CI -1.0 to 3.6; primary analysis time points). Fewer patients in the PainSMART-group reported worsening.
CONCLUSION: Combining the PainSMART-strategy with usual physiotherapy management did not result in additional clinically meaningful benefits once physiotherapy had commenced. During waiting times, the strategy may facilitate earlier improvements in MSKP-perceptions, self-efficacy and physical activity for some. This type of educational intervention is scalable within primary care.
CLINICAL TRIALS REGISTRATION: The study protocol (2023-12-15) and statistical analysis plan (2024-09-25) were prospectively registered at ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT06187428) and the study protocol published (https://doi.org/10.1371/journal.pone.0316806).