Effectiveness of a Pain Informed Movement Program in Individuals With Post-COVID-19 Condition: A Randomized Controlled Trial

Abstract

Objective: To evaluate the early effect of the Pain Informed Movement (PIM) program in patients with post-COVID-19 condition experiencing new-onset persistent pain.

Design: A single-blind, two-arm, parallel-group, randomized controlled trial.

Setting: Public health sciences faculty.

Participants: Fifty-seven patients (N=57) with post-COVID-19 condition were randomized into the PIM (n=27) and the control (usual care and educational booklet) groups (n=30).

Interventions: Patients in the intervention group received an 8-week PIM program. Each week, participants attended 2 face-to-face sessions of 1 hour per week. The first session was group-based and focused on pain neuroscience education. The second session was individual and consisted of functional exercises and relaxation techniques. Additionally, patients were required to perform these exercises and techniques at home twice a week, recording their compliance and progress.

Main outcome measures: Measured outcomes include pain intensity and interference measured with the Brief Pain Inventory (BPI), catastrophizing assessed with the Pain Catastrophizing Scale (PCS), kinesiophobia measured with the Tampa Kinesiophobia Scale (TSK) and functionality assessed using World Health Organization Disability Assessment Schedule (WHODAS 2.0). Participants were assessed at baseline and postintervention.

Results: The intervention group showed a significant reduction in all variables with respect to baseline values. In addition, the intervention group showed significant differences with respect to the control group in pain intensity (MD=2.84±0.62; P<.001; Cohen's d=.21), pain interference (MD=3.10±0.70; P<.001; Cohen's d=1.18), catastrophizing (MD=12.52±2.48; P<.001; Cohen's d=1.34), kinesiophobia (MD=8.07±1.34; P<.001; Cohen's d=1.56) and functionality (MD=16.16±6.92; P= .039; Cohen's d=0.62).

Conclusions: In conclusion, the PIM program appears to be an effective intervention for reduction of new-onset persistent pain and improvement of functionality in patients with post-COVID-19 condition. This study underscores the importance of multidimensional and personalized approaches to persistent pain management, although more research is needed to confirm its applicability in clinical practice.

Keywords: Catastrophization; Kinesiophobia; Pain Management; Post–COVID condition; Recovery of Function; Rehabilitation.