Interdisciplinary behavioral rehabilitation of pediatric pain-associated disability: retrospective review of an inpatient treatment protocol.
OBJECTIVE
A biopsychosocial model was used to treat pain-associated disability in children and adolescents. We assessed the clinical outcomes of children and adolescents (8-21 years of age) with pain-associated disability who were treated in an interdisciplinary inpatient rehabilitation program which included physical, occupational, and recreational therapy, medicine, nursing, pediatric psychology, neuropsychology, psychiatry, social work, and education. Psychological treatment emphasized cognitive-behavioral intervention for pain and anxiety management, and behavioral shaping to increase functioning.


METHODS
We conducted a retrospective chart review of 41 consecutive patients. School attendance, sleep, and medication usage were assessed at admission and discharge; functional disability and physical mobility were assessed at admission, discharge, and 3-month follow-up.


RESULTS
As a group, significant improvements were observed in school status, sleep, functional ability, physical mobility, and medication usage.


CONCLUSIONS
Findings support the efficacy of an inpatient interdisciplinary behavioral rehabilitation approach to the treatment of pain-associated disability in pediatric patients.
Maynard
Cynthia S
CS
Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. maynard@kennedykrieger.org
Amari
Adrianna
A
Wieczorek
Beth
B
Christensen
James R
JR
Slifer
Keith J
KJ
D000293:Adolescent; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D002648:Child; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008499:Medical Records; D009043:Motor Activity; D010146:Pain / Q000150:complications* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D012890:Sleep; D016896:Treatment Outcome; D055815:Young Adult