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Completed

NCT Number: NCT06821022

The Impact of Pain Neuroscience Education on Physical Therapy Students' Knowledge, Attitudes, Beliefs, and Behaviors Towards Pain: A Randomized Controlled Trial

This study investigates the effect of pain neuroscience education (PNE) on pain knowledge, attitudes, beliefs and behaviors among undergraduate physiotherapy students in Jordan

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Key information

Conditions

Healthy Subjects Behavior Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The Hashemite University

Zarqa, Zarqa Governorate, 13133, Jordan

About this study

Physiotherapy students at the Hashemite University will be randomly assigned into either pain neuroscience education or control lectures groups. Both groups will receive a 70-min didactic group-lecture. The control group will receive education about red-flags which are special screening questions for serious pathology. The red-flags education will discuss tissue pathology and triage for back pain classification. Neurophysiology and the biopsychosocial mode will not be discussed. The intervention group will receive a PNE lecture. All primary and secondary outcome measures consist of validated questionnaires (e.g., RNPQ, HC-PAIRS), except for the study-specific red-flags knowledge test; the study-specific case vignette assessing guideline-concordant low back pain recommendations underwent validation testing before participant recruitment.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Physiotherapy undergraduate students at the Hashemite University

Exclusion criteria

  • Previous formal pain education
  • Enrolled in a clinical practice module

Treatment and study plan

Pain neuroscience education

Other

The intervention group will receive a lecture of 70min duration on pain neuroscience. The objective of this educational session is to educate students that pain can be overprotective, and that nociceptive transmission can be heavily influenced by central sensitisation (sensitivity of the central nervous system) as well as the thoughts and beliefs of the individual. The session used drawings, stories and metaphors to depict the underlying neuroscience of pain, and current pain theory.

Red Flags Education

Other

The control group received an education session of red flags. Red flags form part of routine subjective practice for therapists as a process of screening serious or potentially sinister pathologies. Sign and symptoms for such pathologies include history of cancer, systemic symptoms such as fever or unexplained weight loss, and saddle analgesia. The red flag session will not include the neuroscience of pain.

Primary outcomes

  1. Revised Pain Neurophysiology Questionnaire (RNPQ)

    Time frame: Before and immediately after and 6 months after the education session

    The 12-item RNPQ will be used to assess knowledge of pain neurophysiology. Responses are marked yes, no or undecided. One point is awarded for correct answers. Scores range from 0 to 12, with high scores indicating good knowledge.

  2. The modified HC-PAIRS

    Time frame: Prior to and immediately and 6 months after the education session

    The modified HC-PAIRS (Health Care Providers' Pain and Impairment Relationship Scale will be used to measure attitudes and beliefs towards patients with chronic pain and their ability to function. This 13-item questionnaire uses a 7-point Likert scale (strongly disagree to strongly agree). Scores range from 13 to 91 with lower scores suggesting more positive attitudes.

Secondary outcomes

  1. Guideline-concordant low back pain recommendations assessed using a case vignette

    Time frame: Baseline, immediately after the education session, and 6 months after the education session.

    A case vignette will be used to assess participants' vignette-based clinical recommendations for a patient with non-specific low back pain. Participants will answer four multiple-choice questions addressing recommendations regarding usual daily activities, work, exercise, and bed rest. Each domain will be scored as guideline-concordant or non-guideline-concordant according to contemporary low back pain guideline recommendations. The total number of guideline-concordant recommendations will be calculated, with possible scores ranging from 0 to 4; higher scores indicate more guideline-concordant recommendations. The percentage of guideline-concordant recommendations may also be reported. The vignette was developed for this study and psychometrically evaluated before participant recruitment and before its use as a trial outcome, including expert review for content validity, cognitive pretesting, construct validity assessment, test-retest reliability, and measurement error analysis.

Other outcomes

  1. LBP Red-Flags Knowledge Quiz (10-item)

    Time frame: Baseline, Post, and 6 months after lecture control session

    It is a 10-item quiz, with yes/no answers that assesses knowledge of red-flags. Scores range from 0 to 10. This questionnaire was developed within our team. This is to provide attention-matched control content and to support participant blinding to the vignette outcome. This tool is developed de novo to provide attention-matched control content and to evaluate knowledge of red-flag indicators of serious spinal pathology. This is a de novo instrument developed and face validated for this trial. The face validation process, conducted prior to participant recruitment.

Sponsors and collaborators

Lead sponsor

The Hashemite University

Other

Registry information

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Feb 11, 2025
Registry last updated
May 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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