{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T14:02:13Z","timestamp":1791122533239,"version":"4.1.0"},"reference-count":83,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Chronic pain is a prevalent and disabling condition that affects physical health but also cognitive domains. Executive functions, including inhibitory control, cognitive flexibility, and working memory, essentials for self-regulation, treatment adherence, and coping with symptoms, are particularly compromised. Physiotherapy interventions, traditionally aimed at physical outcomes, may also influence executive functions; however, their impact remains unclear. Objective: This review aimed to synthesize current evidence regarding the effects of physiotherapy-related interventions on executive function in adults with chronic pain. Methods: The review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42024611800). A comprehensive search was performed. Randomized controlled trials (RCTs) included adults with chronic pain (\u22653 months) whose executive function outcomes were evaluated after physiotherapy-based interventions. Results: Out of 12,391 records, 10 randomized controlled trials were included. Populations primarily had fibromyalgia, chronic low back pain, and chronic musculoskeletal pain. Interventions encompassed transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (rTMS), neurofeedback, structured exercise, and multimodal physical-cognitive-mindfulness training. Intervention durations ranged from one session to 16 weeks. Executive function was assessed with diverse neuropsychological tests. tDCS improved attention, inhibitory control, cognitive flexibility, and working memory. Exercise interventions showed benefits in working memory and inhibitory control. Conclusions: Preliminary evidence suggests that physiotherapy interventions, particularly anodal tDCS and structured exercise, may improve executive functions in individuals with chronic pain. Future trials should incorporate long-term follow-up. Integrating cognitive targets into physiotherapy may enhance the multidimensional management of chronic pain.<\/jats:p>","DOI":"10.3390\/neurolint18030055","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:32:07Z","timestamp":1773667927000},"page":"55","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of Physiotherapy Interventions on Executive Function in Patients with Chronic Pain: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"given":"Aser","family":"Donado-Bermejo","sequence":"first","affiliation":[{"name":"Escuela Internacional de Doctorado, Rey Juan Carlos University, 28008 Madrid, Spain"},{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"},{"name":"Faculty of Health Sciences, UNIE University, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-9557","authenticated-orcid":false,"given":"Silvia","family":"Di-Bonaventura","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"},{"name":"PainCorp Foundation, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Barrenechea-Leal","sequence":"additional","affiliation":[{"name":"Escuela Internacional de Doctorado, Rey Juan Carlos University, 28008 Madrid, Spain"},{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-4986","authenticated-orcid":false,"given":"Francisco","family":"Mercado-Romero","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"},{"name":"Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1013-7997","authenticated-orcid":false,"given":"Marisa","family":"Fern\u00e1ndez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"},{"name":"Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Ferrer-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"},{"name":"Clinico-Educational Research Group on Rehabilitation Sciences (INDOCLIN), Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid, 28023 Madrid, Spain"},{"name":"Centro de Salud Entrev\u00edas, Gerencia Asistencial de Atenci\u00f3n Primaria de la Comunidad de Madrid, 28023 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1097\/j.pain.0000000000000160","article-title":"A Classification of Chronic Pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e010364","DOI":"10.1136\/bmjopen-2015-010364","article-title":"Prevalence of Chronic Pain in the UK: A Systematic Review and Meta-Analysis of Population Studies","volume":"6","author":"Fayaz","year":"2016","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/SPC.0b013e3283458fa9","article-title":"The Economics Associated with Persistent Pain","volume":"5","author":"Phillips","year":"2011","journal-title":"Curr. 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