Perceived stress and pain interference in acute rehabilitation following spinal cord injury: Resilience as a moderator.
Elizabeth J Richardson, Emily C McKinley, J Scott Richards
PMID 38127538WHAT IT FOUND
During acute spinal cord injury rehab, high resilience did not stop stress from worsening pain intensity.
But for patients with low resilience, every point of stress increased pain interference. Screening for resilience may help identify those most vulnerable to stress-related disability.
Key findings
01Resilience did not significantly moderate the relationship between perceived stress and pain intensity during inpatient rehabilitation.
02For participants with low resilience, higher perceived stress was associated with greater pain interference; this link was absent in those with moderate or high resilience.
03Neuropathic pain symptoms were a significant predictor of pain interference during inpatient rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The results are limited to adults in acute inpatient rehabilitation and may not apply to those in later stages of recovery or community settings. The sample included a higher proportion of men, limiting generalizability to women with SCI. Pain intensity was averaged across all sites without distinguishing between neuropathic and nociceptive pain subtypes. The study did not control for mental health diagnoses such as PTSD, which could influence both stress and resilience. The design was cross-sectional within the acute window, so it cannot establish causality or long-term trajectories.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).
The easy way to misread this
Do not assume that building resilience will directly reduce pain intensity. The study found resilience did not moderate the link between stress and pain intensity, only pain interference. Furthermore, the effect was observed only in those with low resilience, so high resilience did not guarantee lower interference in this specific analysis.