Department of Physical and Occupational Therapy, Boston Children's Hospital, Boston, MA, USA.
Mayo Family Pediatric Pain Rehabilitation Center, Boston Children's Hospital, Boston, MA, USA.
Disabil Rehabil. 2023 Sep;45(19):3079-3086. doi: 10.1080/09638288.2022.2125083. Epub 2022 Sep 21.
This study aimed to (1) examine improvements in rehabilitation outcomes after participation in a pediatric hybrid intensive interdisciplinary pain treatment model (50% in-person and 50% video-based telehealth) and (2) compare magnitude of hybrid model improvements to patients treated in a traditional, 100% in-person model prior to the pandemic.
Rehabilitation outcomes for 33 youth with chronic pain from the model were compared to 33 youth with chronic pain who completed a traditional, in-person model. Improvements between admission and discharge in both models were examined using paired student -tests. Independent samples -tests compared change scores for the hybrid and traditional models.
Participants in both models experienced significant improvements on all rehabilitation outcomes, including cardiovascular endurance, pain interference, functional disability, and occupational performance ( < 0.001), except for pain intensity ( = 0.15). Change scores for rehabilitation outcomes did not significantly differ between models.
Quantitatively, hybrid model rehabilitation outcomes appeared clinically equivalent to the traditional, in-person model. Qualitative and psychosocial outcome comparisons of each model are warranted to better understand challenges and barriers associated with hybrid pain treatment models. The feasibility and impact of tools to enhance telehealth, such as actigraphy or virtual reality, should also be explored.IMPLICATIONS FOR REHABILITATIONThis study supports the efficacy of video-based telehealth interventions for children and adolescents with chronic pain syndromes.Disability outcomes for a hybrid (50% in-person, 50% video-based telehealth) intensive interdisciplinary pain treatment program appear to be equivalent to patients treated within a fully in-person program.
本研究旨在：（1）考察参与儿科混合强化跨学科疼痛治疗模式（50%面授和 50%基于视频的远程医疗）后康复结果的改善情况；（2）比较混合模式改善的幅度与大流行前接受传统 100%面授模式治疗的患者。
将 33 名患有慢性疼痛的儿童的康复结果与 33 名接受传统面授模式的慢性疼痛儿童进行比较。使用配对学生 t 检验比较两种模式在入院和出院时的改善情况。独立样本 t 检验比较了混合模型和传统模型的变化分数。
两种模式的参与者在所有康复结果上都有显著的改善，包括心血管耐力、疼痛干扰、功能障碍和职业表现（ < 0.001），除了疼痛强度（ = 0.15）。两种模式的康复结果变化分数没有显著差异。
从定量角度来看，混合模型的康复结果似乎与传统的面授模式具有临床等效性。对每种模式的定性和心理社会结果进行比较是必要的，以更好地了解混合疼痛治疗模式相关的挑战和障碍。还应探讨增强远程医疗的可行性和影响，例如活动记录仪或虚拟现实。
本研究支持基于视频的远程医疗干预对患有慢性疼痛综合征的儿童和青少年的疗效。混合（50%面授，50%基于视频的远程医疗）强化跨学科疼痛治疗计划的残疾结果似乎与在完全面授计划中治疗的患者相当。
