Pediatric pain rehabilitation during the COVID-19 pandemic: exploring the effectiveness of a hybrid intensive interdisciplinary pain treatment model

Shulman, Julie; Conroy, Caitlin; Bento, Samantha P.; Bryant, Gabrielle; Jervis, Kelsey; Sethna, Navil F.

doi:10.1080/09638288.2022.2125083

Cited by 3 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study represents one of the first to report on video delivery compared with in-person treatment in pediatric pain, with one other study reporting on and supporting hybrid delivery of intensive interdisciplinary treatment for youth with chronic pain. 51 This study has important caveats. It is likely that the pandemic affected outcomes as almost all youth who enrolled in the trial post-Covid had their lives completely upended with the extended closure of schools and shelter-in-place orders.…”

Section: Discussionmentioning

confidence: 89%

See 1 more Smart Citation

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Simons,

Harrison,

Boothroyd

et al. 2023

Pain

View full text Add to dashboard Cite

Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years; 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of individual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Simons,

Harrison,

Boothroyd

et al. 2023

Pain

View full text Add to dashboard Cite

show abstract

“…Several studies on intensive interdisciplinary pain treatment (IIPT) programs have included objective assessment of physical functioning. These studies showed post-treatment improvements in walking speed (measured by time taken to walk a 10 meter distance); number of sit/stand movements in one minute ( 18 , 19 ); improvements in strength, agility, and coordination from pre to post-treatment using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) ( 20 , 21 ); as well as improved timed run ( 22 ), and balance, dexterity, and exercise tolerance ( 23 , 24 ). Additional work has utilized actigraphy monitoring of physical activity and sleep among youth with chronic pain conditions outside of IIPTs ( 25 , 26 ).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain—a pilot nonrandomized treatment study

Junghans-Rutelonis,

Sim,

Harbeck-Weber

et al. 2024

Front. Pain Res.

View full text Add to dashboard Cite

PurposePersonal informatics devices are being used to measure engagement in health behaviors in adults with chronic pain and may be appropriate for adolescent use. The aim of this study was to evaluate the utilization of a wearable activity tracking device to measure physical activity and sleep among adolescents attending a three-week, intensive interdisciplinary pain treatment (IIPT) program. We also assessed changes in physical activity and sleep from baseline to the treatment phase.MethodsParticipants (57.1% female, average age 15.88, SD = 1.27) wore an activity tracking device three weeks prior to starting and during the treatment program.ResultsOf 129 participants contacted, 47 (36.4%) agreed to participate. However, only 30 (64%) complied with the instructions for using the device prior to programming and during program participation. Preliminary analyses comparing averages from 3-weeks pre-treatment to 3-weeks during treatment indicated increases in daily overall activity minutes, daily step counts, and minutes of moderate to vigorous physical activity (by 353%), as well as a corresponding decrease in sedentary minutes. There was more missing data for sleep than anticipated.ConclusionsWearable activity tracking devices can be successfully used to measure adolescent physical activity in-person, with more difficulty obtaining this information remotely. Adolescents with chronic pain experience improvements in objective measurements of physical activity over the course of a 3-week IIPT program. Future studies may want to spend more time working with pediatric patients on their understanding of how to use trackers for sleep and physical activity.

show abstract

“…19 Pediatric patients with complex regional pain syndrome demonstrated improvements in pain and ability to perform physical activities after participation in an exercise-based IIPT without CBT. 20 Several studies have demonstrated improvements in physical functioning in areas of balance, coordination, speed, agility, strength, dexterity, and exercise tolerance [21][22][23] after participating in an interdisciplinary (CBT included) IIPT. Mirek et al 24 demonstrated positive relationships between changes in several PT measures and overall functioning from pre-IIPT to post-IIPT but did not examine the relationship to follow-up.…”

mentioning

confidence: 99%

Longitudinal Pain Outcomes Following an Intensive Pediatric Pain Rehabilitation Program

Weiss,

Li,

Wang

et al. 2023

The Clinical Journal of Pain

View full text Add to dashboard Cite

Objectives: This study tested performance measures of physical functioning and pain-related psychosocial measures as potential mechanisms of improvements in outcomes following intensive outpatient interdisciplinary pain rehabilitation for adolescents. We hypothesized that improvements in performance measures of physical functioning, fear of pain, pain catastrophizing, and self-efficacy during treatment would be related to improvements in pain, functional disability, and depressive symptoms. Methods: Seventy-seven adolescents, 10-18 years old, completed self-report measures prior to treatment, after the first week, at discharge, and at 3-months follow-up. Participants completed physical performance measures of physical and exercise capacity and core strength on day one, after the first week, and at discharge. Linear mixed models were used to examine the association between changes in potential mechanisms and changes in outcomes, adjusting for age, sex, pain duration and baseline functional disability. Results: Statistically significant improvement in functional disability, pain, and depressive symptoms was demonstrated across the four time points. Improvements were also demonstrated in physical performance measures, fear of pain, pain catastrophizing and self-efficacy. Improvements in pain catastrophizing predicted improvements in functional disability, pain and depressive symptoms. Improvements in self-efficacy predicted improvements in all outcome variables except depression. Improvements in physical performance measures predicted improvements in some aspects of functional disability and pain, but not depressive symptoms. Discussion: This study contributes to the growing literature on the effectiveness of pediatric intensive interdisciplinary pain rehabilitation programs and mechanisms that influence improvements in outcomes, an area that is currently underexplored. Results are important to guide future research and inform clinical practice.

show abstract

Pediatric pain rehabilitation during the COVID-19 pandemic: exploring the effectiveness of a hybrid intensive interdisciplinary pain treatment model

Cited by 3 publications

References 38 publications

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain

Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain—a pilot nonrandomized treatment study

Longitudinal Pain Outcomes Following an Intensive Pediatric Pain Rehabilitation Program

Contact Info

Product

Resources

About