The Role of Neurofeedback Training and Pain Management in Post-operative Shoulder Rehabilitation

The Role of Neurofeedback Training and Pain Management in Post-operative Shoulder Rehabilitation: a Study Connecting Neural Mechanism and Clinical Results

The primary aim is to compare the efficacy of neurofeedback training (NFT) and pain management protocol (PMP) in pain reduction, restoration of shoulder function, and improved cognitive performance as the post-operative rehabilitation protocols in shoulder pain patients.

The primary aim is to compare the efficacy of neurofeedback training (NFT) and pain management protocol (PMP) in pain reduction, restoration of shoulder function, and improved cognitive performance as the post-operative rehabilitation protocols in shoulder pain patients. While the former modulates neural activity, the latter focuses on biopsychosocial aspects of pain, respectively. Also, we will measure the peripheral cytokine levels of rotator cuff injury to clarify the possible role of peripheral inflammation on central neural activities. By incorporating the behavior (both motor and cognition), peripheral inflammation, and neural activity, we believe this study would bridge the gap between mind and body as the "whole person" approach to understanding musculoskeletal pain and its appropriate therapy.

Inclusion Criteria:

• Pain ≥3months and ≥3 days per week
• Pain intensity ≥ 40 (VAS scale from 0 no pain to 100 very painful)
• Participants in the neurofeedback training group and pain management group were asked not to involve other treatment when they are in the 6th-12th week intervention period.
• The surgical indication would be based on orthopedics opinions.

Exclusion Criteria:

• shoulder surgery in the prior 3 years
• osteoporotic vertebral fractures or rheumatologic diseases
• chronic wide- spread pain syndromes (fibromyalgia or chronic fatigue syndrome)
• pain at any other location in addition to shoulder pain
• Neurological disease, i.e., stroke, parkinson's disease, etc..
• Cancer