Multimodal Physiotherapy and Pain Coping in Primary Care

Universitat Jaume I

Status: Begins enrollment in 6 months

Conditions: Chronic Musculoskeletal Pain

Treatments: Behavioral: Multimodal Physiotherapy Program Based on Pain Neuroscience Education and Therapeutic Exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT07299929

DC-GVA-2025

Details and patient eligibility

About

This quasi-experimental, multicenter study aims to evaluate the effectiveness of a multimodal physiotherapy intervention-based on pain neuroscience education and therapeutic exercise-on health-related quality of life in patients with persistent musculoskeletal pain treated in Primary Care.

The study will be conducted in four Primary Care physiotherapy units in the Valencian Community (Spain). A total of at least 68 participants aged 18 to 70 years with nonspecific persistent musculoskeletal pain lasting at least six months will be recruited.

The intervention will consist of a structured multimodal physiotherapy program including educational sessions on pain neuroscience and guided therapeutic exercise. The main outcome will be health-related quality of life, assessed using the SF-36 Health Survey. Secondary outcomes will include pain catastrophizing (Pain Catastrophizing Scale), kinesiophobia (Tampa Scale for Kinesiophobia), and central sensitization (Central Sensitization Inventory), among others.

Data will be collected using the REDCap electronic platform at three time points: baseline (pre-intervention), immediately after the intervention, and six months post-intervention. Statistical analysis will include descriptive statistics, bivariate analyses, and paired comparisons to assess changes over time.

The study seeks to generate evidence on the feasibility and potential effectiveness of implementing a multimodal physiotherapy intervention for active coping with chronic musculoskeletal pain in the context of Primary Care.

Enrollment: 68 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

- Persistent nonspecific musculoskeletal pain lasting at least 6 months

Exclusion criteria

• Oncologic pain.
• Spinal fracture or surgical intervention within the 12 months prior to the intervention.
• Cognitive impairment that prevents comprehension of the intervention content (in case of doubt, the Mini-Mental State Examination will be administered, requiring a minimum score of 25).
• Physical performance deficit that prevents execution of the intervention (minimum requirement: completion of the Timed Up and Go test within the normal time of 10 seconds).
• Pregnancy.
• Cauda equina syndrome.
• Presence of urinary and/or fecal incontinence.
• Severe psychiatric disorders.
• Autoimmune diseases.
• Associated medical conditions that preclude participation in a physical exercise program (e.g., myopathies, neurological diseases with significant functional impairment).
• Patients undergoing alternative therapies.
• Patients with an implanted neurostimulator.

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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68 participants in 1 patient group

Multimodal Physiotherapy Intervention

Experimental group

Description:

Participants will receive a multimodal physiotherapy intervention designed to improve active coping and health-related quality of life in individuals with persistent musculoskeletal pain. The program combines pain neuroscience education sessions with guided therapeutic exercise, delivered by physiotherapists in Primary Care settings. The intervention will be conducted in group sessions over several weeks and will include education on pain mechanisms, movement retraining, and individualized exercise progression.

Treatment:

Behavioral: Multimodal Physiotherapy Program Based on Pain Neuroscience Education and Therapeutic Exercise