fa اثربخشی آموزش علوم اعصاب درد و کنترل حرکتی بر درد، ناتوانی و باورهای اجتناب از ترس در افراد دارای کمر درد مزمن: مروری نظام مند بر مطالعات گذشته مديريت درد مزمن Chronic pain managment مروری Review <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">چکیده</span></span></span></b><span dir="LTR" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span mitra="" style="font-family:"><span style="color:#030303"></span></span></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">مقدمه</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">: کمردرد مزمن (</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">CLBP</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">) یکی از شایع‌ترین مشکلات پزشکی است که ترکیب آموزش علوم اعصاب درد (</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">PNE</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">) و تمرینات کنترل حرکتی</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">(MCE)</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> به‌عنوان یک رویکرد نوین درمانی در این بیماران مورد توجه قرار گرفته است. هدف این مطالعه مروری، بررسی و تحلیل اثر بخشی ترکیب </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">PNE</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> و </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">MCE</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> بر افراد مبتلا به کمردرد مزمن است.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">روش شناسی</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">: جستجوی ادبیات تحقیق شامل مقالات منتشر شده از سال‌ 2015 تا 2025 می باشد که از پایگاه های اطلاعاتی داده</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">PubMed, Google scholar, Scopus, Pro Quest </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">&nbsp;استفاده شد. کلمات کلیدی شامل (کارآزمایی بالینی تصادفی کنترل شده، آموزش علوم اعصاب درد، کمر درد مزمن، تمرینات کنترل حرکتی) </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">و&nbsp; (</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">randomized controlled trial, pain neuroscience education, pain education, pain physiology education, PNE, motor control exercise, MCE, back pain, non-specific chronic low back pain,</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">)</span></span></span> <span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">بود. جهت بررسی کیفیت مقالات وارد شده از مقیاس </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">PEDro</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> استفاده گردید.</span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">یافته ها</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">: از بین </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">8</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> مقاله یافت شده</span></span></span> <span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">تعداد </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">5</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> مقاله معیارهای ورود مطالعه را کسب کردند. این مطالعات به طور عمده اثر&nbsp; </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">PNE</span></span></span> &nbsp;<span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">در ترکیب </span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">با </span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">MCE</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> را مورد مطالعه قرار دادند که </span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">اثرات</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">مثبت</span></span></span> <span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">این دو مداخله</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:"> بر</span></span></span> <span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">این افراد</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">در</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">این</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">مطالعات</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">به</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">ثبت</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">رسیده</span></span></span> <span lang="AR-SA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">است</span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span mitra="" style="font-family:">.</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">بحث و نتیجه گیری</span></span></span></b><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span b="" mitra="" style="font-family:">:</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303"> ترکیب </span></span></span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">PNE</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303"> و </span></span></span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">MCE</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303"> برای بیماران مبتلا به کمردرد مزمن مؤثر است و به کاهش درد، ناتوانی و باورهای اجتناب از ترس کمک می‌کند. </span></span></span></span></span><span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">PNE</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303"> درک بیماران از مکانیسم‌های درد را بهبود می‌بخشد &nbsp;</span></span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303">و همچنین</span></span></span></span></span> <span dir="LTR" style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">MCE</span></span></span><span lang="AR-SA" style="font-size:14.0pt"><span style="background:white"><span style="line-height:107%"><span b="" mitra="" style="font-family:"><span style="color:#030303"> با تقویت قدرت عضلانی و هماهنگی، توانایی افراد در انجام فعالیت‌های روزمره را افزایش داده و ناتوانی ناشی از درد را کاهش می‌دهد.</span></span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:107%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background:white"><span style="line-height:107%"><span style="color:#333333">Abstract</span></span></span></span></strong></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background:white"><span style="line-height:107%"><span style="color:#333333">Introduction</span></span></span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%">: Chronic low back pain (CLBP) is one of the most common medical problems that is a combination of pain neuroscience education (PNE) and motor control exercises (MCE). The aim of this review study is to investigate and analyze the effectiveness of the combination of PNE and MCE on people with chronic low back pain.</span></span></strong></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background:white"><span style="line-height:107%"><span style="color:#333333">Methods:</span></span></span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%"> The literature search included articles published from 2015 to 2025, which were used in the databases PubMed, Google scholar, Scopus, Pro Quest. Keywords included (randomized controlled clinical trial, pain neuroscience education, chronic low back pain, motor control exercises) and (randomized controlled trial, pain neuroscience education, pain education, pain physiology education, PNE, motor control exercise, MCE, back pain, chronic non-specific low back pain,). PEDro was used to assess the quality of the included articles.</span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%"><span style="font-weight:normal"></span></span></span></strong></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background:white"><span style="line-height:107%"><span style="color:#333333">Results:</span></span></span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%"> Of the 8 articles found, 5 articles were included in the study. These studies mainly studied the effect of PNE in combination with MCE, which was positive. These two interventions were recorded on these subjects in these studies.</span></span></strong></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background:white"><span style="line-height:107%"><span style="color:#333333">Conclusion:</span></span></span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%"> The combination of PNE and MCE is for patients with chronic low back pain and helps reduce pain, disability, and fear-avoidance beliefs. PNE improves pain mechanisms and also MCE by strengthening muscle strength and coordination, can increase daily activities and reduce pain-related disability.</span></span></strong><strong><span style="font-size:12.0pt"><span style="line-height:107%"><span style="font-weight:normal"></span></span></span></strong></span></span></span><br> &nbsp; کمر درد مزمن, آموزش علوم اعصاب درد, تمرین کنترل حرکتی, درد, ناتوانی, باورهای اجتناب از ترس Keywords: Chronic low back pain, pain neuroscience education, motor control exercise, pain, disability, fear-avoidance beliefs 65 82 http://jap.iums.ac.ir/browse.php?a_code=A-10-899-1&slc_lang=fa&sid=1 Sina Saeed Askari سینا سعیدعسکری sinasaeedaskari@gmail.com 100319475328460019819 100319475328460019819 Yes Ph.D Student in sports injury and corrective exercises in Shahid Bahonar University of Kerman, Kerman, Iran دانشجوی دکتری آسیب شناسی ورزشی و حرکات اصلاحی ، دانشکده تربیت بدنی و علوم ورزشی ، دانشگاه شهید باهنر کرمان ، کرمان ، ایران Mansour sahebozamani منصور صاحب الزمانی sahebozamani@uk.ac.ir 100319475328460019820 100319475328460019820 No Prof. of Sport Therapy & Sport Rehabilitation Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran استاد گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه شهید باهنر کرمان، کرمان، ایران saeid Bahiraei سعید بحیرایی s.bahiraei@uk.ac.ir 100319475328460019821 100319475328460019821 No Assistant Professor of Adapted Physical Activity Faculty of Physical Education and Sports Science, Shahid Bahonar University of Kerman, Iran استادیار گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه شهید باهنر کرمان، کرمان، ایران