Understanding the impact of positive, neutral and negative expectation speech on the manual therapy treatment in patients with chronic low back pain: a pilot study

• Grant number: 23/03646-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2023
• End date: December 31, 2024
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Thaís Cristina Chaves
• Grantee: Bianca Emanuelli Saes Campanha
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil

Abstract

Background: There is evidence of the effectiveness of manipulative therapy in the treatment of chronic low back pain (CLBP), however, as with most physical therapy interventions, its effect is small. The placebo effect or contextual effect is an important part of the response to any active treatment. Contextual Factors (CFs) can be manipulated to increase the effectiveness of an intervention. One of the mechanisms by which CFs works is by inducing patient expectations, which can be accomplished through verbal instructions. There is a gap in the literature regarding the hypoalgesic effect of inducing expectation on active treatment through manipulative therapy in patients with CLBP. Objective: To investigate the impact, on pain intensity, of positive, neutral, or negative verbal suggestions regarding manual therapy treatment in patients with CLBP. Global Perceived Effect of improvement, empathy, expectations will be assessed as secondary outcomes. In addition, the perception of the patients about the content of the videos.Methods: This is an exploratory randomized clinical trial. Sixty participants aged between 18 and 55 years, with CLBP, will participate in the present study. A researcher not involved in the recruitment of patients will randomly allocate the participants into three different groups (G1- group submitted to positive expectation, G2- group submitted to neutral expectation, and G3- group submitted to negative expectation). The three groups will receive a manual therapy session after watching the video proposed for their groupExpected results: it is expected that the group submitted to positive expectations comunication will have a greater hypoalgesic effect than the other groups immediately post-treatment (video + manual therapy).