Effect of pain neuroscience education after breast cancer surgery on pain, physical, emotional and work-related functioning

EduCan Trial

Project description

Summary

 Over the past decades, awareness on the importance of educational interventions in cancer pain management has increased. However, education is often restricted to biomedical pain management instructions. A more modern educational approach, also known as pain neuroscience education (PNE), explains pain from a biopsychosocial perspective. We hypothesise that this more comprehensive educational approach in the early treatment phase of breast cancer will lead to more beneficial effects for cancer pain management. Therefore, the aim of the present study is to investigate the effectiveness of this PNE intervention, in addition to best evidence physical therapy modalities for treatment and prevention of pain, physical, emotional and work-related functioning after breast cancer surgery, compared with a traditional biomedical educational intervention. A double-blinded randomised controlled trial was conducted from November 2017 until September 2021 at the University Hospitals of Leuven. Immediately after breast cancer surgery, all participants (n=184) receive a 12-week intensive standard physical therapy programme. They receive three additional refresher sessions at 6, 8 and 12 months postsurgery. In addition, participants receive three educational sessions during the first-month postsurgery and three ‘booster sessions’ at 6, 8 and 12 months postsurgery. In the intervention group, the content of the education sessions is based on the modern PNE approach. Whereas in the control group, the education is based on the traditional biomedical approach. The primary outcome parameter is pain-related disability 1 year after surgery. Secondary outcomes related to other dimensions of pain, physical, emotional and work-related functioning at 1-week, 4, 6, 8, 12 and 18 months postsurgery.

Theme(s): Pain, Sensory Dysfunctions, Treatment, Oncology

 

Status
Finished
Starting date
27/11/2017

FWO - Research Foundation Flanders (T005117N)

Principal investigator

Partners

Prof. dr. Nele Devoogdt (Department of Rehabilitation Sciences, KU Leuven; Centre for Lymphedema, University Hospitals Leuven)
Prof. dr. Mira Meeus (Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp)
Prof. dr. Ann Smeets (Department of Surgical Oncology, University Hospitals Leuven)
Prof. dr. Bart Morlion (The Leuven Centre for Algology and Pain Management, University Hospitals Leuven; Department of Cardiovascular Sciences, Section Anaesthesiology and Algology, KU Leuven)
Prof. dr. Lode Godderis (Centre for Environment and Health, KU Leuven; IDEWE, External Service for Prevention and Protection at Work)
Prof. dr. Paul van Wilgen (Department of Physiotherapy Vrije Universiteit Brussel; Transcare, Transdisciplinary Pain Management Centre, Groningen, the Netherlands)
Prof. dr. Niamh Moloney (Department of Health Professions, Macquarie University, Australia; Department of Exercise Sciences, University of Auckland, New Zealand)
Mr. Koen Bernar (The Leuven Centre for Algology and Pain Management, University Hospitals Leuven)
Dr. Elien Van der Gucht (Department of Rehabilitation Sciences, KU Leuven; Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp)
Dr. Lore Dams (Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp; Department of Rehabilitation Sciences, KU Leuven)

Results

Of 184 participants randomized, the mean (SD) age in the PNE and biomedical education group was 55.4 (11.5) and 55.2 (11.4) years, respectively. The change in pain-related disability from baseline to 12 months postoperatively did not differ between the 2 groups (PNE 4.22 [95% confidence interval [CI]: 1.40-7.03], biomedical 5.53 [95% CI: 2.74-8.32], difference in change 21.31 [95% CI: 25.28 to 2.65], P = 0.516). Similar results were observed for all secondary outcomes. Future research should explore whether a more patient-tailored intervention would yield better results.

Funding

FWO - Research Foundation Flanders (T005117N)

Publications

https://pubmed.ncbi.nlm.nih.gov/30612114/
https://pubmed.ncbi.nlm.nih.gov/36637138/
https://pubmed.ncbi.nlm.nih.gov/30612114/
https://pubmed.ncbi.nlm.nih.gov/37171771/

Contact

lore.dams@uantwerpen.be