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      Do Parental Pain Knowledge, Catastrophizing, and Hypervigilance Improve Following Pain Neuroscience Education in Healthy Children?

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          Abstract

          Pediatric chronic pain is a challenging problem for children and their families, although it is still under-recognized and under-treated. The aim of this study was to investigate whether a pain neuroscience education program for children (PNE4Kids) delivered to healthy children aged 8 to 12 years old and attended by their parents would result in improved parental knowledge about pain neurophysiology, decreased parental pain catastrophizing about their own pain and their children’s, decreased parental pain vigilance and awareness, and decreased fear of pain in children. Twenty-seven healthy child–parent dyads received a 45 min PNE4Kids session. Demographic data were collected, and the Neurophysiology of Pain Questionnaire (NPQ), Fear of Pain Questionnaire—Parent Proxy Report (FOPQ-P), Pain Catastrophizing Scale (PCS), Pain Catastrophizing Scale for Parents (PCS-P), and the Pain Vigilance and Awareness Questionnaire (PVAQ) were completed by the parents before and after the PNE4Kids session. Twenty-six dyads completed study participation. In response to the PNE4Kids session, significant short-term (1 week) improvements were shown in the NPQ ( p < 0.001) and the FOPQ-P ( p = 0.002). Parents’ level of pain knowledge and children’s fear of pain, reported by their parents, improved after a 45 min PNE4Kids session. Thus, PNE4Kids should likewise be further investigated in healthy child–parent dyads as it might be useful to target parental and children’s pain cognitions at a young age.

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          Most cited references37

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          The epidemiology of chronic pain in children and adolescents revisited: a systematic review.

          Chronic and recurrent pain not associated with a disease is very common in childhood and adolescence, but studies of pain prevalence have yielded inconsistent findings. This systematic review examined studies of chronic and recurrent pain prevalence to provide updated aggregated prevalence rates. The review also examined correlates of chronic and recurrent pain such as age, sex, and psychosocial functioning. Studies of pain prevalence rates in children and adolescents published in English or French between 1991 and 2009 were identified using EMBASE, Medline, CINAHL, and PsycINFO databases. Of 185 published papers yielded by the search, 58 met inclusion criteria and were reviewed, and 41 were included in the review. Two independent reviewers screened papers for inclusion, extracted data, and assessed the quality of studies. Prevalence rates ranged substantially, and were as follows: headache: 8-83%; abdominal pain: 4-53%; back pain: 14-24%; musculoskeletal pain: 4-40%; multiple pains: 4-49%; other pains: 5-88%. Pain prevalence rates were generally higher in girls and increased with age for most pain types. Lower socioeconomic status was associated with higher pain prevalence especially for headache. Most studies did not meet quality criteria. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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            The child version of the pain catastrophizing scale (PCS-C): a preliminary validation.

            Catastrophizing about pain has emerged as a critical variable in how we understand adjustment to pain in both adults and children. In children, however, current methods of measuring catastrophizing about pain rely on brief subscales of larger coping inventories. Therefore, we adapted the Pain Catastrophizing Scale (Sullivan et al., 1995) for use in children, and investigated its construct and predictive validity in two studies. Study 1 revealed that in a community sample (400 boys, 414 girls; age range between 8 years 9 months and 16 years 5 months) the Pain Catastrophizing Scale for Children (PCS-C) assesses the independent but strongly related dimensions of rumination, magnification and helplessness that are subsumed under the higher-order construct of pain catastrophizing. This three factor structure is invariant across age groups and gender. Study 2 revealed in a clinical sample of children with chronic or recurrent pain (23 girls, 20 boys; age range between 8 years 3 months and 16 years 6 months) that catastrophizing about pain had a unique contribution in predicting pain intensity beyond gender and age, and in predicting disability, beyond gender, age and pain intensity. The function of pain catastrophizing is discussed in terms of the facilitation of escape from pain, and of the communication of distress to significant others.
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              Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain.

              Unhelpful pain cognitions of patients with chronic low back pain (LBP) may limit physical performance and undermine physical assessment. It is not known whether a direct relationship exists between pain cognitions and physical performance. To determine if a relationship exists between change in pain cognitions and change in physical performance when chronic LBP patients participate in a single one-to-one education intervention during which they have no opportunity to be active. In a quasi-experiment using a convenience sample, moderately disabled chronic LBP patients (n=121) participated in a one-to-one education session about either lumbar spine physiology or pain physiology. Multiple regression analysis evaluated the relationship between change in pain cognitions measured by the survey of pain attitudes (SOPA) and the pain catastrophising scale (PCS) and change in physical performance, measured by the straight leg raise (SLR) and standing forward bending range. There was a strong relationship between cognitive change and change in straight leg raise (SLR) and forward bending (r=0.88 and 0.79, respectively, P<0.01), mostly explained by change in the conviction that pain means tissue damage and catastrophising. Change in pain cognitions is associated with change in physical performance, even when there is no opportunity to be physically active. Unhelpful pain cognitions should be considered when interpreting physical assessments.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Children (Basel)
                Children (Basel)
                children
                Children
                MDPI
                2227-9067
                20 May 2021
                May 2021
                : 8
                : 5
                : 420
                Affiliations
                [1 ]Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium; pere.bacardit.pinto@ 123456vub.be (P.B.P.); Emma.Rheel@ 123456vub.be (E.R.); Margot.Paula.Iwens@ 123456vub.be (M.I.); jo.nijs@ 123456vub.be (J.N.); Roselien.pas@ 123456vub.be (R.P.)
                [2 ]Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussel, Belgium
                [3 ]Research Foundation—Flanders (FWO), Egmontstraat 5, 1000 Brussel, Belgium
                [4 ]Department of Experimental-Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Gent, Belgium
                [5 ]Pain in Motion International Research Group; Mira.meeus@ 123456uantwerpen.be
                [6 ]MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp (UA), 2610 Wilrijk, Belgium
                [7 ]Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Campus UZ, Ghent University, 9000 Ghent, Belgium
                [8 ]Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
                Author notes
                [* ]Correspondence: kelly.ickmans@ 123456vub.be ; Tel.: +32-(0)2-477-45-03
                Author information
                https://orcid.org/0000-0002-8338-3582
                https://orcid.org/0000-0003-0751-6504
                https://orcid.org/0000-0001-5299-261X
                https://orcid.org/0000-0002-4976-6563
                Article
                children-08-00420
                10.3390/children8050420
                8161245
                302d75e7-30e4-4f0c-8f4a-51023153c9cd
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 25 March 2021
                : 17 May 2021
                Categories
                Article

                pain neuroscience education,healthy children,parents,pain knowledge,fear of pain,pain catastrophizing

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