Brazilian Journal of Pain
Brazilian Journal of Pain
Review Article

ConheceDOR: the development of a board game for modern pain education for patients with musculoskeletal pain

ConheceDOR: desenvolvimento de um jogo de tabuleiro para educação moderna em dor para pessoas com dor musculoesquelética

Juliana Carvalho de Paiva Valentim; Ney Armando Meziat-Filho; Leandro Calazans Nogueira; Felipe J. Jandre Reis

Downloads: 1
Views: 313


BACKGROUND AND OBJECTIVES: Chronic pain is one of the main challenges for health systems. Pain education and self-motivated strategies have great potential in the treatment of people with chronic pain, especially by modifying beliefs and behavior. The development of board games for educational purposes can contribute to the learning of pain concepts and behavioral strategies. The objective of this study was to develop a board game (ConheceDor) to be used as an intervention tool for pain education.

CONTENTS: The systematic review for the development of the game ConheceDor, considered the following search strategy: "chronic pain", "musculoskeletal pain", "health education", "patient education", "neuroscience education", "pain education", "therapeutic neuroscience education". The primary outcomes considered were pain intensity and disability. Fifteen studies were included, with a total of 1,486 participants. Six studies reported reduction on pain of at least 10%, and two studies reported an improvement of at least 30% on disability. For the development of the game, we elaborated the layout of the board, the rules and other components (dice, cards, and pins). The cards of the game included the contents commonly used in the randomized controlled trials: negative thoughts, pain neurophysiology, stress management, and relaxation, coping and exercises.

CONCLUSION: The development of the present board game was based on the critical appraisal of the content of educational strategies present in the literature. The board game can be a potent resource to be applied in clinical practice in people with musculoskeletal pain.


Chronic pain, Experimental games, Health education, Neuroscience-based education


JUSTIFICATIVA E OBJETIVOS: A dor crônica é um dos principais desafios para os sistemas de saúde. As estratégias comportamentais e a educação em dor apresentam grande potencial no tratamento de pessoas com dor crônica, especialmente pela modificação de crenças e do comportamento. Os jogos de tabuleiro podem ser uma estratégia educativa que contribui para a aprendizagem dos conceitos sobre dor e estratégias comportamentais. O objetivo deste estudo foi desenvolver um jogo de tabuleiro (ConheceDor) como ferramenta de intervenção para educação em dor.

CONTEÚDO: A revisão sistemática para o desenvolvimento do jogo ConheceDor, considerou a estratégia de busca com os descritores "chronic pain", "musculoskeletal pain", "health education", "patient education","neuroscience education", "pain education", "therapeutic neuroscience education". Os desfechos primários considerados foram a intensidade da dor e a incapacidade. Foram incluídos 15 estudos com um total de 1.486 participantes. Seis estudos apresentaram redução da dor de pelo menos 10% e dois estudos atingiram uma melhora de pelo menos 30% na incapacidade. Para o desenvolvimento do jogo foram elaborados o layout do tabuleiro, as regras e os demais componentes (dados, cartas, pinos). As cartas do ConheceDor incluíram os temas mais utilizados nos estudos identificados que foram: pensamentos negativos, neurofisiologia da dor, manuseio do estresse e relaxamento, enfrentamento e exercícios físicos.

CONCLUSÃO: A criação de um jogo de tabuleiro considerou uma análise crítica da literatura dos conteúdos das estratégias educativas presentes nos ensaios clínicos. O desenvolvimento dessa intervenção pode ser um recurso para ser aplicado na prática clínica em pessoas com dor musculoesquelética.


Dor crônica, Educação com base em neurociência, Educação em saúde, Jogos experimentais


Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-59.

Simons LE, Elman I, Borsook D. Psychological processing in chronic pain: a neural systems approach. Neurosci Biobehav Rev. 2014;39:61-78.

Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14(7):502-11.

Crofford LJ. Psychological aspects of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2015;29(1):147-55.

Flor H, Turk DC. Chronic pain: an integrated biobehavioral approach. 2015.

Okifuji A, Turk DC. Behavioral and cognitive-behavioral approaches to treating patients with chronic pain: thinking outside the pill box. J Ration Cogn Ther. 2015;33(3):218-38.

Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17(2):165-72.

Sullivan MJ, Rodgers WM, Kirsch I. Catastrophizing, depression and expectancies for pain and emotional distress. Pain. 2001;91(1-2):147-54.

Brox JI, Storheim K, Grotle M, Tveito TH, Indahl A, Eriksen HR. Systematic review of back schools, brief education, and fear-avoidance training for chronic low back pain. Spine J. 2008;8(6):948-58.

Engers A, Jellema P, Wensing M, van der Windt DA, Grol R, van Tulder MW. Individual patient education for low back pain. Cochrane Database Syst Rev. 2008.

Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Physiother Theory Pract. 2016;32(5):332-55.

Nascimento SS. Efeitos neurofisiológicos de terapias cognitivas no manejo da dor: revisão sistemática. 2018.

Vygotsky LS. A formação social da mente. 1984.

Nicoletti AA, Filho R. Aprender brincando: a utlização de jogos, brinquedos e brincadeiras como recursos pedagógicos. Rev Divulg Técnico-Científica ICPG. 2004;2(5):91-4.

Chiauzzi E, Pujol LA, Wood M, Bond K, Black R, Yiu E. painACTION-back pain: a self-management website for people with chronic back pain. Pain Med. 2010;11(7):1044-58.

Rizzo RR, Medeiros FC, Pires LG, Pimenta RM, McAuley JH, Jensen MP. Hypnosis enhances the effects of pain education in patients with chronic non-specific low back pain: a randomized controlled trial. J Pain. 2018;19(10).

Ryan CG, Gray HG, Newton M, Granat MH. Pain biology education and exercise classes compared to pain biology education alone for individuals with chronic low back pain: a pilot randomised controlled trial. Man Ther. 2010;15(4):382-7.

Moseley GL, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004;20(5):324-30.

Nicholas MK, Asghari A, Blyth FM, Wood BM, Murray R, McCabe R. Long-term outcomes from training in self-management of chronic pain in an elderly population: A randomized controlled trial. Pain. 2017;158(1):86-95.

LeFort SM, Gray-Donald K, Rowat KM, Jeans ME. Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain. Pain. 1998;74(2-3):297-306.

Thorn BE, Day MA, Burns J, Kuhajda MC, Gaskins SW, Sweeney K. Randomized trial of group cognitive behavioral therapy compared with a pain education control for low-literacy rural people with chronic pain. Pain. 2011;152(12):2710-20.

Gallagher L, McAuley J, Moseley GL. A randomized-controlled trial of using a book of metaphors to reconceptualize pain and decrease catastrophizing in people with chronic pain. Clin J Pain. 2013;29(1):20-5.

Carmody TP, Duncan CL, Huggins J, Solkowitz SN, Lee SK, Reyes N. Telephone-delivered cognitive-behavioral therapy for pain management among older military veterans: a randomized trial. Psychol Serv. 2013;10(3):265-75.

Brage K, Ris I, Falla D, Søgaard K, Juul-Kristensen B. Pain education combined with neck-and aerobic training is more effective at relieving chronic neck pain than pain education alone-A preliminary randomized controlled trial. Man Ther. 2015;20(5):686-93.

Ris I, Søgaard K, Gram B, Agerbo K, Boyle E, Juul-Kristensen B. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up. Man Ther. 2016;26:132-40.

Meeus M, Nijs J, Van Oosterwijck J, Van Alsenoy V, Truijen S. Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial. Arch Phys Med Rehabil. 2010;91(8):1153-9.

Van Oosterwijck J, Meeus M, Paul L, De Schryver M, Pascal A, Lambrecht L. Pain physiology education improves health status and endogenous pain inhibition in fibromyalgia: a double-blind randomized controlled trial. Clin J Pain. 2013;29(10):873-82.

Andersen LN, Juul-Kristensen B, Sørensen TL, Herborg LG, Roessler KK, Søgaard K. Efficacy of tailored physical activity or chronic pain self-management programme on return to work for sick-listed citizens: a 3-month randomised controlled trial. Scand J Public Health. 2015;43(7):694-703.

Bennell KL, Nelligan R, Dobson F, Rini C, Keefe F, Kasza J. Effectiveness of an internet-delivered exercise and pain-coping skills training intervention for persons with chronic knee pain: A randomized trial. Ann Intern Med. 2017;166(7):453-62.

Mendez SP, Sá KN, Araújo PC, Oliveira IA, Gosling AP, Baptista AF. Elaboration of a booklet for individuals with chronic pain. Rev Dor. 2017;18(3):199-211.

Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: short-and long-term outcomes of pain and disability. Eur J Pain. 2018.

Geneen LJ, Martin DJ, Adams N, Clarke C, Dunbar M, Jones D. Effects of education to facilitate knowledge about chronic pain for adults: a systematic review with meta-analysis. Syst Rev. 2015;4:132.

Beinner MA, Morais EA, Reis IA, Reis EA, Oliveira SR. O uso de jogo de tabuleiro na educação em saúde sobre dengue em escola pública. J Nurs UFPE online. 2015;9(4):7304-13.

Olympio PC, Alvim NA. Board games: gerotechnology in nursing care practice. Rev Bras Enferm. 2018;71(^sSuppl 2):818-26.

Fernandes CS, Martins MM, Gomes BP, Gomes JA, Gonçalves LH. Family nursing game: desenvolvendo um jogo de tabuleiro sobre família. Esc Anna Nery. 2016;20(1):33-7.

Pires MR, Guilhem D. Jogo (IN) DICA-SUS: estratégia lúdica na aprendizagem sobre o Sistema Único de Saúde. Texto Context Enferm. 2013;22(2):379-88.

Aizencang N. Jugar, aprender y enseñar. Relac que potencian los aprendizajes. 2005.

Reis FJ, Bengaly AG, Valentim JC, Santos LC, Martins EF, O'Keeffe M. An E-Pain intervention to spread modern pain education in Brazil. Braz J Phys Ther. 2017;21(5):305-6.

Submitted date:

Accepted date:

5f21d6d70e8825ae25e56d7d brjp Articles


Share this page
Page Sections