Online pain neuroscience education and graded exposure to movement in breast cancer survivors: Randomised controlled trial

Purpose: To evaluate the effectiveness of an online, person-centred programme combining pain neuroscience education (PNE) and graded exposure to movement (GEM) for quality of life improvement in breast cancer survivors.  Methods: This single-blind randomised controlled trial included a sample of 49 breast cancer survivors who were randomly assigned to two groups (experimental: n = 22 and control: n = 27). The experimental group received a 12-week online programme based on pain neuroscience education and therapeutic yoga as gradual exposure to movement, while the control group continued with their usual care. The primary outcome was quality of life (FACT –B+4); the secondary outcomes were related to the experience of chronic pain ( pain intensity and pain interference,catastrophizing, pain self-efficacy, kinesiophobia and fear avoidance behaviours). All variables were assessed at 4 time points. For data analysis, ANOVA (2x4) analysis of variance was used (95% CI). Results : 36 participants were included in the analysis (control group: 22; experimental group: 14). A significant time*group effect was observed in favour of the experimental group regarding the global quality of life measure (p = 0.010, η p 2 = 0,124). Significant between-groups differences in favour of the experimental group were observed for pain intensity and pain interference, catastrophizing and pain self-efficacy. Except for pain interference, these differences persisted at follow-up.  Conclusions : An online intervention based on PNE and GEM seems to be effective for the improvement of quality of life and chronic pain in breast cancer survivors. However, due to the study limitations further research is needed.  Trial record: NCT04965909 (26/06/2021).