The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial

Motor control disorder in patients with chronic non-specific low back pain (NSCLBP) can change the plantar pressure distribution, increase the spine loading, and lead to the development of NSCLBP. The present study aimed to determine the effect of adding pain neuroscience education to motor control exercises in water and dry environments on plantar pressure distribution symmetry in women with NSCLBP.

This clinical trial was conducted in 2024 at Bu Ali Sina University, Hamadan. Sixty women with NSCLBP were conveniently selected and randomly assigned into experimental and control groups (n=30). The experimental group received motor control exercises in water and land environments along with neuroscience education for 4 weeks, and the control group did not receive any intervention. Pain intensity, kinesiophobia, and plantar pressure distribution were assessed in the pre-test and post-test stages. Multivariate analysis of covariance (MANCOVA) was used to analyze the data.

Comparison of the results between the groups showed that there was a significant difference in pain reduction (p<0.001), kinesiophobia (p<0.001), and improvement in plantar pressure distribution symmetry in the experimental group compared to the control group (p<0.001).

Combination of neuroscience education and motor control exercises over a 4-week period significantly reduced pain intensity and kinesiophobia with a medium effect size and improved the plantar pressure distribution symmetry. Therefore, it is suggested that physiotherapists consider the mentioned exercises for the rehabilitation of patients with NSCLBP Keywords: Chronic non-specific low back pain, Plantar pressure distribution, Motor control, Pain neuroscience training, Hydrotherapy

Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics committee of Bu-Ali Sina University approved the study (IR.BASU.REC.1402.095).
Authors’ contributions:- Conceptualization: Ali Yalfani, Fatemeh Sori
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Ali Yalfani, Fatemeh Sori
- Data collection: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Formal analysis: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor
- Supervision: Ali Yalfani
- Project administration: Ali Yalfani
- Writing – original draft: Ali Yalfani
- Writing – review & editing: Fatemeh Sori, Mohammadreza Ahmadi, Azadeh Asgarpoor





Citation: Sori F, Yalfani A, Ahmadi MR, Asgarpoor A. The Effect of Adding Pain Neuroscience Education to Motor Control Exercises in Water and Dry Environments on Plantar Pressure Distribution Symmetry in Women with Non-Specific Chronic Low Back Pain: A Clinical Trial.  J Rafsanjan Univ Med Sci 2025; 23 (12): 1076-92. [Farsi]