Motor control exercises and pain education in individuals with chronic nonspecific low back pain: randomized clinical feasibility trial

Nörnberg, Suendi Stifft; Costa, Gabriela Rodrigues; Decker, Ana Júlia da Rosa; Araújo, Francisco Xavier de; Vilarino, Guilherme Torres; Junkes-Cunha, Maíra

doi:10.63231/2595-0118.20250002-pt

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ORIGINAL ARTICLE • Brazilian Journal of Pain 8 • 2025 • https://doi.org/10.63231/2595-0118.20250002-en linkcopy

Motor control exercises and pain education in individuals with chronic nonspecific low back pain: randomized clinical feasibility trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES To investigate the feasibility of an intervention program in the context of Primary Health Care in the southern region of Brazil, through exercises and pain education, focusing on the management of chronic low back pain, and thus identify possible modifications that may be necessary before a definitive intervention.

METHODS Randomized clinical feasibility study. 20 individuals with chronic low back pain were recruited. Participants were allocated into three distinct groups: 1) motor control exercises; 2) pain education approach; 3) the combination of these two interventions. The quantitative outcomes were: recruitment rate, acceptance to participate in the interventions and retention. In addition, the following criteria were assessed qualitatively or by online questionnaire: barriers to interventions, adherence to treatment, satisfaction with treatment, logistics, financial viability and human and material resources.

RESULTS The total recruitment, acceptance and retention rates were 100%, 50% and 80% intra-group, respectively; acceptance and retention were 57% and 50% in group 1 and 85% and 100% in group 2. The satisfaction and logistics rated as “excellent” by the participants were: the content covered (66.7%), the availability of timetables (55.6%) and the material resources (66.7%). The main barriers encountered were work schedule compatibility, a greater number of sessions and inclement weather.

CONCLUSION This research concluded that a clinical trial to evaluate the effectiveness of an intervention program using exercises and pain education in the management of chronic low back pain is feasible and justified, although some modifications are necessary.

Keywords:
Chronic pain; Low back pain; Feasibility studies; Public health

HIGHLIGHTS

Recruitment, retention and acceptance rates were satisfactory

The findings on feasibility are pioneering in clinical studies and chronic low back pain

Exercises and education in the management of chronic low back pain are feasible and justified

The data presented will allow the proposal to be refined in future studies

	n (%)	Mean	Standard deviation
Pain intensity (NPRS)	15 (75%)	5.27	±2.42
Disabling (RMDQ)	4 (20%)	10.25	±4.29
Kinesiophobia (TSK)	15 (75%)	40.9	±8.55
Depression (BDI)	10 (50%)	11.95	±8.15
Anxiety (BAI)	9 (45%)	11.45	±9.23
Sleep quality (PSQI)	14 (70%)	8.7	±4.31
Fear belief (FABQ - PA)	14 (70%)	18.5	±6.78
Fear belief (FABQ - WA)	12 (60%)	22.8	±17.35
Left algometry	NA	5.74	±4.60
Right algometry	NA	5.75	±4.03

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Sociedade Brasileira para o Estudo da Dor Av. Conselheiro Rodrigues Alves, 937 Cj2 - Vila Mariana, CEP: 04014-012, São Paulo, SP - Brasil, Telefones: , (55) 11 5904-2881/3959 - São Paulo - SP - Brazil
E-mail: dor@dor.org.br

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[1] NPRS = Numeric Pain Rating Scale; RMDQ = Roland Morris Disability Questionnaire; TSK = Tampa Scale for Kinesiophobia; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory; PSQI = Pittsburgh Sleep Quality Index; FABQ = Fear Avoidance Belief Questionnaire; PA = physical activity; WA = work activities; NA = not applicable.

Variables	n = 20	%
Gender
Male	7	35%
Female	13	65%
Age range
18 to 30 years old	7	35%
31 to 45 years old	5	25%
46 to 59 years old	7	35%
60 years or older	1	5%
Education
Incomplete elementary education	2	10%
Complete high school	4	20%
Incomplete higher education	7	35%
Complete higher education	6	30%
Complete postgraduate degree	1	5%
Occupation
Students	5	25%
Teachers	4	20%
Health professionals	2	10%
Religious service providers	2	10%
Other	7	35%
Family income
Between 1 and 2 minimum wages	6	30%
Between 2 and 3 minimum wages	4	20%
Between 4 and 6 minimum wages	4	20%
Between 7 and 9 minimum wages	3	15%
More than 10 minimum wages	3	15%

	n		%
Recruitment rate	20		100
Acceptance rate	10		50
G1	4		57
G2	6		85
G3	0		0
Retention rate	8		80
G1	2		50
G2	6		100
Satisfaction and logistics	Excellent	Good	Regular	Unsatisfactory
Content covered	66.7%	22.2%	0%	11.1%
Number of appointments	55.6%	33.3%	11.1%	0%
Travel	44.4%	33.3%	22.2%	0%
Availability of schedules	55.6%	33.3%	11.1%	0%
Material resources	66.7%	33.3%	0%	0%