An interventional study of Pain Neuroscience Education and Red Flags Education in Healthy Subjects, sponsored by The Hashemite University. Completed at 1 site in Jordan. Per ClinicalTrials.gov, last updated 2026-05-15.
Sponsored by The Hashemite University · Not applicable, Interventional, and Health services research
This study investigates the effect of pain neuroscience education (PNE) on pain knowledge, attitudes, beliefs and behaviors among undergraduate physiotherapy students in Jordan
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.
10,054 studies on the registry are indexed under Pain; 1,649 are open to participants now.
This study's enrollment of 120 is above the median of 66 across 8,493 interventional studies indexed under Pain.
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Exclusion Criteria:
Other: Pain Neuroscience Education
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.
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.
Revised Pain Neurophysiology Questionnaire (RNPQ)
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.
Time frame: Before and immediately after and 6 months after the education session
The modified HC-PAIRS
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.
Time frame: Prior to and immediately and 6 months after the education session
Guideline-concordant low back pain recommendations assessed using a case vignette
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.
Time frame: Baseline, immediately after the education session, and 6 months after the education session.
LBP Red-Flags Knowledge Quiz (10-item)
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.
Time frame: Baseline, Post, and 6 months after lecture control session
Plan to share: Yes — After completion of the data collection, it will be analysed and then interpreted. I will provide you with the study results and recommendations upon completion.
Supporting information: Statistical analysis plan
Time frame: After being published, the dataset and/or the statistical analyses will be made available for interested researchers upon reasonable request.
Access criteria: After being published, the dataset and/or the statistical analyses will be made available for interested researchers upon reasonable request.
This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.
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The Hashemite University