PTOTCohortJournal of pediatric rehabilitation medicine2024

Does diagnosis matter? Evaluating impact of pediatric chronic pain diagnosis on pain and function.

Cara Vernacchia, Diane Amstutz, Benjamin Petrie and 2 others

PMID 39269859

WHAT IT FOUND

Children with chronic pain improved in pain and function after an interdisciplinary program, regardless of diagnosis.

Most baseline differences between pain types disappeared by discharge, though those with widespread pain continued to show more emotional impairment.

Key findings

01Pain scores and functional impairment (BAPQ domains) significantly decreased from initial evaluation to discharge and follow-up across the whole cohort.

02Baseline functional differences existed between diagnoses, but most were no longer evident by discharge, indicating the program was effective across varied pain types.

03Children with widespread pain (WP) retained higher emotional dysfunction scores at discharge compared to the overall cohort, suggesting a need for targeted psychological support.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study was retrospective, relying on clinical charts not designed for research, which may result in incomplete data. Social determinants of health, such as socioeconomic status and race, were not collected, limiting the ability to adjust for these factors. The contribution of individual components of the interdisciplinary program (e.g., PT vs. psychology) cannot be separated, as all patients received the combined package. Follow-up was short (one to two months) and had a high dropout rate (245 of 488 patients), so long-term sustainability of gains is unknown. The study did not analyze individual patient trajectories, only group averages.

Declared interests

The authors have no financial interests to disclose.

The easy way to misread this

Do not assume that children with widespread pain will respond to treatment in the same way as other groups. While physical function improved, emotional dysfunction remained significantly higher in this group at discharge, indicating they may need continued or more intensive psychological support after the program ends.

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