Musculoskeletal PainNCT07005778
Effects of Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students
A study testing Traditional pain education and PNE-based education in people with Musculoskeletal Pain, run by Akdeniz University at 1 site in Turkey (Türkiye).
Trial summary
The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Musculoskeletal Pain
- What is being tested?
- Traditional pain education and PNE-based education
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 41 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 12 Dec 2024to 12 Mar 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Students were eligible to participate if they were undergraduate physiotherapy assistant students enrolled at the Vocational School of Health Services.
Who cannot join
- Individuals were excluded if they had previously received in-depth teaching on pain neurophysiology or traditional pain education.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Traditional Pain Education and Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students
The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. The main questions this study aims to answer are:
Does a single-session PNE-based education improve students' beliefs about the relationship between pain and disability? Does it reduce reliance on biomedical (organic) pain beliefs compared to traditional pain education? In this study, researchers will compare PNE-based education to traditional pain education, both delivered through 70-minute lectures.
Read more
Participants were randomly assigned to either the PNE group or the traditional education group, attended a one time 70-minute classroom lecture, completed questionnaires at three time points: before the session, immediately after, and 3 months later.
The main tools used will be the Health Care Providers' Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Pain Beliefs Questionnaire (PBQ), which includes organic and psychological subscales.
This study aims to support the integration of contemporary pain neuroscience content into physiotherapy assistant curricula to enhance biopsychosocial understanding at an early stage of professional education.
Read the detailed description
In Turkey, research on the impact of pain neuroscience education (PNE) on the knowledge, beliefs, and attitudes of undergraduate physiotherapy students remains scarce. Moreover, there appears to be no study that directly contrasts traditional pain education with a PNE-based approach that conceptualizes pain as an outcome-driven process, enriched with metaphors and storytelling. Existing literature suggests that physiotherapy assistant programs often provide limited exposure to neuroscience content, which may contribute to the lack of significant improvements in students' understanding and attitudes toward pain following PNE.
Against this background, the current study was developed to explore how a metaphor-supported, case-based PNE intervention influences the pain-related knowledge and beliefs of physiotherapy assistant students. To the best of our knowledge, no prior study in Turkey has systematically evaluated the effects of PNE within this specific student group. Therefore, a randomized controlled trial was designed to compare the outcomes of traditional structural pain education and a neuroscience-based educational program on pain-related beliefs and attitudes among physiotherapy assistant students.
- Conditions
- Musculoskeletal Pain
- Being tested
- Traditional pain education, PNE-based education
- Medical subject headings
- Musculoskeletal Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Traditional pain educationOther
Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury.
PNE-based educationOther
Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors.
Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience.
| Study group | Role | What they receive |
|---|---|---|
| Traditional Pain Education | Active comparator | Participants in the control group received a 70-minute lecture based on the biomedical model of pain. Receives: Other: Traditional pain education |
| PNE based education | Experimental | Students in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. Receives: Other: PNE-based education |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Health Care Pain Attitudes and Impairment Relationship Scale
The HC-PAIRS is a 12-item scale that measures healthcare providers' beliefs about how much pain leads to disability in low back pain cases, using a 7-point Likert scale. Higher scores indicate more negative attitudes. The Turkish version was validated and showed strong reliability (ICC = 0.85).
Measured: Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.
Secondary outcomes (1)
Pain Beliefs Questionnaire
The Pain Beliefs Questionnaire (PBQ) is a 12-item tool designed to assess individuals' beliefs about pain, divided into two subscales: Organic (8 items) and Psychological (4 items). The Organic subscale reflects beliefs about the physical causes of pain, while the Psychological subscale focuses on the influence of emotional and mental states such as anxiety and relaxation. Items are rated on a 6-point scale ranging from "always" to "never." Subscale scores are calculated by summing the relevant items. The PBQ can be used with healthy individuals and has been shown to have valid and reliable psychometric properties in its Turkish version.
Measured: Participants completed the Pain Beliefs Questionnaire at baseline, Day 1 and 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jun 2025
- Study start12 Dec 2024
- Primary completion12 Dec 2024
- Study completion12 Mar 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Musculoskeletal PainStudies of the same condition, open and under way.
- More trials run by Akdeniz UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 41 participants (actual)
Sponsor and investigators
- Lead sponsor
- Akdeniz University
- Sponsor type
- University, hospital or other
- Collaborators
- Pamukkale University
- Responsible party
- Principal investigator, Hatice Gül, Akdeniz University
- Investigators
- Hatice Gül, Principal investigator, Akdeniz University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07005778
- Sponsor's protocol ID
- 03.10.2024, TBAEK-683
- Status last verified
- Jun 2025
- First submitted
- 26 May 2025
- Last updated
- 5 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Since the dataset includes personal data, it is not planned to be shared.
Publications
Mankelow J, Ryan C, Taylor P, Martin D. The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial. Musculoskelet Sci Pract. 2020 Dec;50:102249. doi: 10.1016/j.msksp.2020.102249. Epub 2020 Aug 28.
PubMed 32920228Cox T, Louw A, Puentedura EJ. An abbreviated therapeutic neuroscience education session improves pain knowledge in first-year physical therapy students but does not change attitudes or beliefs. J Man Manip Ther. 2017 Feb;25(1):11-21. doi: 10.1080/10669817.2015.1122308. Epub 2016 Feb 10.
PubMed 28855788Colleary G, O'Sullivan K, Griffin D, Ryan CG, Martin DJ. Effect of pain neurophysiology education on physiotherapy students' understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial. Physiotherapy. 2017 Dec;103(4):423-429. doi: 10.1016/j.physio.2017.01.006. Epub 2017 Mar 22.
PubMed 28797666Gul H, Erel S. Pain Neuroscience Education Versus Traditional Pain Education on Pain Attitudes and Beliefs of Physiotherapy Assistant Students: A Randomized-Controlled Trial. Physiother Res Int. 2026 Apr;31(2):e70187. doi: 10.1002/pri.70187.
PubMed 41782373
Study at a glance
From the registry record, last updated by the sponsor on 5 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Traditional Pain Education and Pain Neuroscience Education on Pain Attitudes and Beliefs in Physiotherapy Assistant Students
- ClinicalTrials.gov ID
- NCT07005778
- Acronym / sponsor ID
- 03.10.2024, TBAEK-683
- Conditions
- Musculoskeletal Pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 41 participants (actual)
- Lead sponsor
- Akdeniz UniversityUniversity, hospital or other
- Collaborators
- Pamukkale University
- Study start
- 12 Dec 2024 (actual)
- Primary completion
- 12 Dec 2024 (actual)
- Study completion
- 12 Mar 2025 (actual)
- First posted
- 5 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this educational trial is to learn whether Pain Neuroscience Education (PNE) improves pain-related attitudes and beliefs in physiotherapy assistant (PTA) students in Turkey compared to traditional pain education. The main questions this study aims to answer are:
Does a single-session PNE-based education improve students' beliefs about the relationship between pain and disability? Does it reduce reliance on biomedical (organic) pain beliefs compared to traditional pain education? In this study, researchers will compare PNE-based education to traditional pain education, both delivered through 70-minute lectures.
Participants were randomly assigned to either the PNE group or the traditional education group, attended a one time 70-minute classroom lecture, completed questionnaires at three time points: before the session, immediately after, and 3 months later.
The main tools used will be the Health Care Providers' Pain Attitudes and Impairment Relationship Scale (HC-PAIRS) and the Pain Beliefs Questionnaire (PBQ), which includes organic and psychological subscales.
This study aims to support the integration of contemporary pain neuroscience content into physiotherapy assistant curricula to enhance biopsychosocial understanding at an early stage of professional education.
Detailed description
In Turkey, research on the impact of pain neuroscience education (PNE) on the knowledge, beliefs, and attitudes of undergraduate physiotherapy students remains scarce. Moreover, there appears to be no study that directly contrasts traditional pain education with a PNE-based approach that conceptualizes pain as an outcome-driven process, enriched with metaphors and storytelling. Existing literature suggests that physiotherapy assistant programs often provide limited exposure to neuroscience content, which may contribute to the lack of significant improvements in students' understanding and attitudes toward pain following PNE.
Against this background, the current study was developed to explore how a metaphor-supported, case-based PNE intervention influences the pain-related knowledge and beliefs of physiotherapy assistant students. To the best of our knowledge, no prior study in Turkey has systematically evaluated the effects of PNE within this specific student group. Therefore, a randomized controlled trial was designed to compare the outcomes of traditional structural pain education and a neuroscience-based educational program on pain-related beliefs and attitudes among physiotherapy assistant students.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Traditional Pain Education | Active comparator | Other: Traditional pain educationParticipants in the control group received a 70-minute lecture based on the biomedical model of pain. |
| PNE based education | Experimental | Other: PNE-based educationStudents in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Students were eligible to participate if they were undergraduate physiotherapy assistant students enrolled at the Vocational School of Health Services.
Key exclusion criteria (1 listed)
- Individuals were excluded if they had previously received in-depth teaching on pain neurophysiology or traditional pain education.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Traditional pain educationParticipants in the control group received a 70-minute lecture based on the biomedical model of pain. Educational content included anatomical pathways for pain process (receptors, Aδ and C fibers, spinal cord, and ascending tracts), mechanisms of action potential generation, and the Gate Control Theory. The role of the brain was briefly addressed in the context of descending inhibition. While the Neuromatrix Theory was mentioned, the presentation lacked metaphorical or narrative-based content. Case examples centered on inflammation and tissue injury. | Other | Traditional Pain Education |
| PNE-based educationStudents in the intervention group received a 70-minute lecture grounded in the biopsychosocial model of pain. The session emphasized that pain is not a direct result of tissue damage, but rather a complex and context-dependent output of the brain. The lecture explored how pain emerges from the brain's interpretation of various inputs, including sensory signals, prior experiences, beliefs, emotions, and environmental factors. Instructional strategies included the use of clinically relevant metaphors and storytelling to promote reconceptualization of pain. Examples such as "the alarm system" were used to illustrate peripheral and central sensitization, while real-life anecdotes (a player unaware of injury during a game or a nail-in-foot case with no significant damage) highlighted the dissociation between nociception and pain experience. | Other | PNE based education |
Primary outcome
The Health Care Pain Attitudes and Impairment Relationship Scale
Time frame: Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.
The HC-PAIRS is a 12-item scale that measures healthcare providers' beliefs about how much pain leads to disability in low back pain cases, using a 7-point Likert scale. Higher scores indicate more negative attitudes. The Turkish version was validated and showed strong reliability (ICC = 0.85).
1 secondary outcome
Pain Beliefs Questionnaire
Time frame: Participants completed the Pain Beliefs Questionnaire at baseline, Day 1 and 3 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jun 2025.
- Results publication: PubMed 32920228Mankelow J, Ryan C, Taylor P, Martin D. The effect of pain neurophysiology education on healthcare students' knowledge, attitudes and behaviours towards pain: A mixed-methods randomised controlled trial. Musculoskelet Sci Pract. 2020 Dec;50:102249. doi: 10.1016/j.msksp.2020.102249. Epub 2020 Aug 28.
- Results publication: PubMed 28855788Cox T, Louw A, Puentedura EJ. An abbreviated therapeutic neuroscience education session improves pain knowledge in first-year physical therapy students but does not change attitudes or beliefs. J Man Manip Ther. 2017 Feb;25(1):11-21. doi: 10.1080/10669817.2015.1122308. Epub 2016 Feb 10.
- Results publication: PubMed 28797666Colleary G, O'Sullivan K, Griffin D, Ryan CG, Martin DJ. Effect of pain neurophysiology education on physiotherapy students' understanding of chronic pain, clinical recommendations and attitudes towards people with chronic pain: a randomised controlled trial. Physiotherapy. 2017 Dec;103(4):423-429. doi: 10.1016/j.physio.2017.01.006. Epub 2017 Mar 22.
- Derived from this study: PubMed 41782373Gul H, Erel S. Pain Neuroscience Education Versus Traditional Pain Education on Pain Attitudes and Beliefs of Physiotherapy Assistant Students: A Randomized-Controlled Trial. Physiother Res Int. 2026 Apr;31(2):e70187. doi: 10.1002/pri.70187.
- Individual participant dataSharing planned: No. Since the dataset includes personal data, it is not planned to be shared.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Hatice Gül principal investigator
Akdeniz University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Traditional pain education and PNE-based education in people with Musculoskeletal Pain, run by Akdeniz University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The Health Care Pain Attitudes and Impairment Relationship Scale (time frame: Participants completed the HC-PAIRS at baseline, Day 1 and 3 months.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07005778, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jun 2025.