Functional disability in adolescents with chronic pain: comparing an interdisciplinary exposure program to usual care

Carolien Dekker, Mariëlle Goossens*, Bjorn Winkens, Silvia Remerie, Caroline Heuts - Bastiaenen, Jeanine Verbunt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

(1) Background: Chronic musculoskeletal pain (CMP) in adolescents can negatively affect physical, psychological, and social functioning, resulting in functional disability. This randomized controlled trial (RCT) aimed to evaluate the effectiveness of an outpatient rehabilitation program based on graded exposure in vivo (EP) compared with care as usual (CAU: interdisciplinary outpatient rehabilitation care). Both EP and CAU aim to improve functional ability in adolescents with CMP. (2) Methods: Pragmatic multicenter RCT with 12-month follow-up. Adolescents (12-21 years) with CMP were invited to participate. Primary outcome: functional disability; secondary outcomes: perceived harmfulness; pain catastrophizing; pain intensity. Data analysis: intention-to-treat linear mixed model. (3) Results: Sixty adolescents (mean 16 years) were randomized; data for 53 were analyzed. Adolescents in EP showed relevant and significant decreases in functional disability (estimated mean difference at least -8.81, p ≤ 0.01) compared with CAU at all times. Significant differences in favor of EP were found for perceived harmfulness at all times (p ≤ 0.002), for pain catastrophizing at 2 months (p = 0.039) and for pain intensity at 4 and 10 months (p ≤ 0.028). (4) Conclusion: EP leads to a significant and clinically relevant decrease in functional disability compared with usual care.

Original languageEnglish
Article number288
Number of pages15
JournalChildren-Basel
Volume7
Issue number12
DOIs
Publication statusPublished - 11 Dec 2020

Keywords

  • chronic musculoskeletal pain
  • adolescents
  • functional disability
  • multidisciplinary rehabilitation
  • RANDOMIZED CONTROLLED-TRIAL
  • MUSCULOSKELETAL PAIN
  • PSYCHOMETRIC PROPERTIES
  • FEAR-AVOIDANCE
  • DUTCH VERSION
  • IN-VIVO
  • CHILDREN
  • REHABILITATION
  • QUESTIONNAIRE
  • INVENTORY

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