Pain neuroscience education for children with functional abdominal pain related disorders : a randomized controlled pilot study

Introduction: Pain Neuroscience Education (PNE) is an educational intervention aimed to increase a person’s knowledge about the neurophysiological basis of pain. Research in adults provides firm evidence regarding its positive effects on pain ratings, dysfunctions, fear-avoidance –and pain catastrophizing, limitations in movement, pain knowledge and healthcare utilization. The aim of this study was to explore the effectiveness and feasibility of a PNE program for children with functional abdominal pain-related disorders (FAPD). Methods:Children aged between 6-12 years and diagnosed with FAPD were randomly assigned to either the experimental or control group, both receiving two treatment sessions with a 3-week time interval between the sessions. Treatment was directed towards the child, while the parent was present. The experimental group received; 1) usual care including bio-medical directed education about the gastro-intestinal system and breathing exercises and 2) a PNE session (PNE4Kids). Similar to adult PNE, PNE4kids included the explanation about the cause of pain, a brief summary of relevant pain mechanisms and the integral role of psychosocial and physical factors in precipitating and maintaining pain. The control group received two usual care sessions. Pressure algometry and conditioned pain modulation were assessed at baseline and three weeks’ follow-up. The child’s pain intensity, functional disability, pain-related fear, as well as parental pain catastrophizing were assessed at baseline, after each treatment session and three weeks’ follow-up. Data analysis of the intervention outcomes will include linear mixed models and descriptive statistics for feasibility outcomes. Results: Twenty-eight participants were allocated to either the experimental (n=14) or control group (n=14). Intervention and feasibility outcomes concerning the study design and procedures such as; participation willingness, participation rates, loss to follow-up, assessment timescale, and assessment procedure are pending and will be presented at the congress. Discussion: Data resulting from this explorative study will lay the foundation for larger randomized trials in the future. Process evaluation: Due to the lack of a control group receiving no intervention, this study will not provide data regarding the isolated effect of PNE4Kids. The main limitation of this study is the use of parent-proxy questionnaires to assess pain-related outcomes in children. References: Pas R, Meeus M, Malfliet A, Baert I, Oosterwijck SV, Leysen L, et al. Development and feasibility testing of a Pain Neuroscience Education program for children with chronic pain: treatment protocol. Brazilian J Phys Ther. 218;22(3):248–53. Robins H, Perron V, Heathcote L, Simons L. Pain Neuroscience Education: State of the Art and Application in Pediatrics. Children [Internet]. 216;3(4):43. Available from: http://www.mdpi.com/2227-967/3/4/43 Louw A, Zimney K, Puentedura EJ, Diener I, Louw A, Zimney K, et al. The efficacy of pain neuroscience education on musculoskeletal pain : A systematic review of the literature. Physiother Theory Pract [Internet]. Taylor & Francis; 216;32(5):332–55. Available from: http://dx.doi.org/1.18/9593985.216.119464