The added value of cognitive behavioral therapy for insomnia to current best evidence physical therapy for chronic spinal pain: protocol of a randomized controlled clinical trial.
Chronic pain
Low back pain
Neck pain
Randomized controlled trial
Journal
Brazilian journal of physical therapy
ISSN: 1809-9246
Titre abrégé: Braz J Phys Ther
Pays: Brazil
ID NLM: 101615124
Informations de publication
Date de publication:
Historique:
received:
27
09
2018
revised:
12
10
2018
accepted:
16
10
2018
pubmed:
6
11
2018
medline:
15
6
2019
entrez:
4
11
2018
Statut:
ppublish
Résumé
Insomnia is a highly prevalent and debilitating comorbidity that is often not addressed in therapy for chronic spinal pain (CSP). Given the close interaction between insomnia and CSP severity and related disability, targeting sleep problems during therapy could improve treatment outcomes in these patients. Can cognitive behavioral therapy for insomnia (CBT-I) combined with the modern neuroscience approach (i.e. pain neuroscience education and cognition-targeted exercise therapy) reduce pain and improve sleep, physical activity and function in people with CSP and comorbid insomnia? Participants: One-hundred-twenty participants with chronic spinal pain and comorbid insomnia Intervention: CBT-I combined with the modern neuroscience approach (experimental) compared to the modern neuroscience approach alone (control). Both interventions start with three sessions of pain neuroscience education, followed by six sessions of CBT-I and nine sessions of cognition-targeted exercise therapy in the experimental group, or 15 sessions of cognition-targeted exercise therapy in the control group. Primary outcome measure: self-reported pain severity (Brief Pain Inventory). pain sensitivity (pressure pain thresholds, and online questionnaires), sleep-related outcomes (home-based polysomnography and online questionnaires), physical activity (actigraphy), and function (online questionnaires). Online questionnaires will be completed at baseline, directly post-treatment, and at 3, 6 and 12 months post-treatment. Polysomnography, pressure pain thresholds and actigraphy will be carried out at baseline, post-treatment and at 12 months follow-up. Findings may provide (1) a novel therapeutic approach for people with CSP and comorbid insomnia to improve pain, sleep, physical activity and function, and (2) new treatment guidelines for professionals. Clinicaltrials.gov NCT03482856 (https://clinicaltrials.gov/ct2/show/NCT03482856).
Sections du résumé
BACKGROUND
BACKGROUND
Insomnia is a highly prevalent and debilitating comorbidity that is often not addressed in therapy for chronic spinal pain (CSP). Given the close interaction between insomnia and CSP severity and related disability, targeting sleep problems during therapy could improve treatment outcomes in these patients.
OBJECTIVE
OBJECTIVE
Can cognitive behavioral therapy for insomnia (CBT-I) combined with the modern neuroscience approach (i.e. pain neuroscience education and cognition-targeted exercise therapy) reduce pain and improve sleep, physical activity and function in people with CSP and comorbid insomnia?
METHODS
METHODS
Participants: One-hundred-twenty participants with chronic spinal pain and comorbid insomnia Intervention: CBT-I combined with the modern neuroscience approach (experimental) compared to the modern neuroscience approach alone (control). Both interventions start with three sessions of pain neuroscience education, followed by six sessions of CBT-I and nine sessions of cognition-targeted exercise therapy in the experimental group, or 15 sessions of cognition-targeted exercise therapy in the control group.
MEASUREMENTS
METHODS
Primary outcome measure: self-reported pain severity (Brief Pain Inventory).
SECONDARY OUTCOME MEASURES
METHODS
pain sensitivity (pressure pain thresholds, and online questionnaires), sleep-related outcomes (home-based polysomnography and online questionnaires), physical activity (actigraphy), and function (online questionnaires). Online questionnaires will be completed at baseline, directly post-treatment, and at 3, 6 and 12 months post-treatment. Polysomnography, pressure pain thresholds and actigraphy will be carried out at baseline, post-treatment and at 12 months follow-up.
DISCUSSION
CONCLUSIONS
Findings may provide (1) a novel therapeutic approach for people with CSP and comorbid insomnia to improve pain, sleep, physical activity and function, and (2) new treatment guidelines for professionals.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov NCT03482856 (https://clinicaltrials.gov/ct2/show/NCT03482856).
Identifiants
pubmed: 30389347
pii: S1413-3555(18)30804-9
doi: 10.1016/j.bjpt.2018.10.007
pmc: PMC6546904
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03482856']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
62-70Informations de copyright
Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.
Références
J Psychosom Res. 2002 Feb;52(2):69-77
pubmed: 11832252
Pain Res Manag. 2002 Summer;7(2):75-9
pubmed: 12185371
Clin J Pain. 2004 Sep-Oct;20(5):309-18
pubmed: 15322437
Pain. 2005 Jan;113(1-2):9-19
pubmed: 15621359
Eur J Pain. 2006 May;10(4):353-61
pubmed: 16051509
J Headache Pain. 2006 Feb;7(1):21-6
pubmed: 16440140
J Sleep Res. 2007 Mar;16(1):85-95
pubmed: 17309767
Sleep. 2007 Nov;30(11):1547-54
pubmed: 18041487
Clin J Pain. 2007 Nov-Dec;23(9):760-6
pubmed: 18075402
Sleep Med. 2010 Mar;11(3):302-9
pubmed: 20133188
BMC Med. 2010 Mar 24;8:18
pubmed: 20334633
Cochrane Database Syst Rev. 2010 Jul 07;(7):CD002014
pubmed: 20614428
Sleep. 2011 May 01;34(5):601-8
pubmed: 21532953
Psychooncology. 2012 Jul;21(7):695-705
pubmed: 21538678
Chest. 2011 Jun;139(6):1514-1527
pubmed: 21652563
Lancet. 2012 Feb 4;379(9814):482-91
pubmed: 21982256
Behav Res Ther. 2012 Nov;50(11):685-9
pubmed: 22982083
Behav Res Ther. 2012 Dec;50(12):814-21
pubmed: 23123531
Cochrane Database Syst Rev. 2012 Nov 14;11:CD007407
pubmed: 23152245
Lancet. 2012 Dec 15;380(9859):2197-223
pubmed: 23245608
Sleep Med Rev. 2014 Aug;18(4):321-31
pubmed: 24135493
Lancet. 2014 Jan 25;383(9914):309-20
pubmed: 24452042
PLoS One. 2014 Mar 25;9(3):e92158
pubmed: 24667276
Pain Physician. 2014 Sep-Oct;17(5):401-14
pubmed: 25247898
Sleep Med Clin. 2014 Jun 1;9(2):261-274
pubmed: 25477769
Clin J Pain. 2016 Jul;32(7):624-30
pubmed: 26418360
Occup Med (Lond). 2016 Aug;66(6):496-7
pubmed: 27067913
Psychiatry Res. 1989 May;28(2):193-213
pubmed: 2748771
Disabil Rehabil. 2018 Jan;40(1):1-9
pubmed: 27871193
Nat Sci Sleep. 2017 Jun 06;9:171-180
pubmed: 28652835
Braz J Phys Ther. 2017 Sep - Oct;21(5):378-387
pubmed: 28736211
Pain Pract. 2018 Apr;18(4):544-554
pubmed: 28851012
Behav Sleep Med. 2019 Jul-Aug;17(4):437-458
pubmed: 29065269
Pain. 2018 Mar;159(3):481-495
pubmed: 29194127
J Pain. 2018 Mar;19(3):317-329
pubmed: 29198933
Phys Ther. 2018 May 1;98(5):325-335
pubmed: 29425327
JAMA Neurol. 2018 Jul 1;75(7):808-817
pubmed: 29710099
Pain. 1987 Jul;30(1):115-26
pubmed: 3614975
Med Care. 1993 Mar;31(3):247-63
pubmed: 8450681