Vernacchia Cara, Amstutz Diane, Petrie Benjamin, Gohil Kavita, Revivo Gadi
Department of Physical Medicine & Rehabilitation, Shirley Ryan Ability Lab, Chicago, Illinois, USA.
Department of Physical Medicine & Rehabilitation, McGaw/Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Pediatr Rehabil Med. 2024 Sep;17(3):328-335. doi: 10.3233/PRM-230064.
This study aimed to A) evaluate changes in pain and function following an outpatient interdisciplinary pain management program (IPMP) for children with different chronic pain conditions and B) explore differences in pain and function at baseline and discharge for different diagnoses.
A retrospective chart review was performed for 488 children who participated in an outpatient IPMP. Children's pain and physical, social, and emotional functioning were assessed at initial evaluation, discharge, and one-to-two-month follow-up. Patients were stratified by diagnosis (complex regional pain syndrome [CRPS], headache, musculoskeletal pain, visceral pain, and widespread pain) to evaluate differences in pain and functioning at baseline and discharge.
Children's pain and function improved from initial evaluation to discharge. Those with headache and musculoskeletal pain exhibited better baseline physical and emotional functioning than other diagnostic groups ( = 0.03; = 0.005; = 0.002; = 0.04). Children with CRPS displayed the worst baseline physical functioning ( = 0.003). Those with widespread pain exhibited the worst baseline emotional functioning at both initial evaluation and discharge ( = 0.009; = 0.007).
Children with CRPS, visceral pain, and widespread pain undergoing treatment in an IPMP exhibited the most impaired baseline functioning, while those with musculoskeletal pain and headache were least impaired. All exhibited improvements in pain and function following the IPMP.
本研究旨在A）评估针对患有不同慢性疼痛病症的儿童开展门诊多学科疼痛管理项目（IPMP）后疼痛和功能的变化，以及B）探讨不同诊断在基线和出院时疼痛和功能的差异。
对488名参与门诊IPMP的儿童进行回顾性病历审查。在初始评估、出院时以及一至两个月的随访中评估儿童的疼痛以及身体、社交和情感功能。根据诊断（复杂性区域疼痛综合征[CRPS]、头痛、肌肉骨骼疼痛、内脏疼痛和广泛性疼痛）对患者进行分层，以评估基线和出院时疼痛和功能的差异。
从初始评估到出院，儿童的疼痛和功能有所改善。患有头痛和肌肉骨骼疼痛的儿童在基线时的身体和情感功能比其他诊断组更好（=0.03；=0.005；=0.002；=0.04）。患有CRPS的儿童基线身体功能最差（=0.003）。患有广泛性疼痛的儿童在初始评估和出院时基线情感功能最差（=0.009；=0.007）。
在IPMP中接受治疗的患有CRPS、内脏疼痛和广泛性疼痛的儿童基线功能受损最严重，而患有肌肉骨骼疼痛和头痛的儿童受损最小。所有儿童在IPMP后疼痛和功能均有改善。
